Kaplan R A, Markman M, Lucas W E, Pfeifle C, Howell S B
Am J Med. 1985 Jan;78(1):49-53. doi: 10.1016/0002-9343(85)90461-9.
A total of 32 episodes of infectious peritonitis developed in 90 patients receiving intraperitoneal chemotherapy. Staphylococcus epidermidis was the organism most commonly cultured, accounting for 65 percent of isolates. Result of initial gram stain was positive in 35 percent of cases. The development of fever and abdominal pain as well as rising peripheral and peritoneal fluid white blood cell counts was helpful in the making of a diagnosis of infectious peritonitis. Seventy-five percent of patients were cured with antibiotic therapy alone whereas one quarter also required removal of the semi-permanent catheter. Patients treated with intraperitoneal chemotherapy delivered by dialysis exchange over several days exhibited significantly more episodes of infection than patients treated by a single-drug instillation each month. Although the development of bacterial peritonitis remains a problem during intracavitary chemotherapy, the use of subcutaneous ports and meticulous sterile technique during catheter manipulation will hopefully decrease the risk of occurrence of this potentially avoidable complication.
90例接受腹腔化疗的患者共发生32次感染性腹膜炎。表皮葡萄球菌是最常培养出的病原体，占分离菌株的65%。35%的病例初始革兰氏染色结果为阳性。发热、腹痛以及外周血和腹腔积液白细胞计数升高有助于诊断感染性腹膜炎。75%的患者仅用抗生素治疗即可治愈，而四分之一的患者还需要拔除半永久性导管。与每月单次注入药物治疗的患者相比，通过透析交换进行数天腹腔化疗的患者感染发作明显更多。尽管在腔内化疗期间细菌性腹膜炎的发生仍然是一个问题，但使用皮下端口以及在导管操作过程中采用细致的无菌技术有望降低这种潜在可避免并发症的发生风险。
