Grefberg N
Scand J Urol Nephrol Suppl. 1983;72:1-46.
Clinical aspects of Continuous Ambulatory Peritoneal Dialysis (CAPD) were studied in the first fifty patients started on CAPD at our hospital. CAPD was found to achieve good control of the uremic symptoms and of the biochemical values studied. Hypertension became less pronounced. The costs were found to be low. Twenty-four diabetic subjects were studied in detail. Intraperitoneal administration of insulin resulted in good metabolic control of the diabetes. The two catheters used for peritoneal access were compared. Because of problems related to the removal of the Toronto Western Hospital catheter it was concluded that the Tenckhoff catheter was to be preferred. Peritonitis was found to be the worst complication. Coagulase negative staphylococci accounted for 57% of the cases. During the study an increasing percentage of infections were caused by bacteria with multiple resistance to antibiotics. Netilmicin, a new aminoglycoside, was evaluated for the treatment of CAPD-related peritonitis. 84% of the cases responded. One of the nineteen patients treated sustained reversible vestibular toxicity. No other side effects were noted. In two patients right-sided hydrothorax was found to be a complication of peritoneal dialysis. In one case it was demonstrated that defects in the right diaphragm was the cause of the complication. In the other CAPD was continued despite the complication.
我们对我院开始接受持续性非卧床腹膜透析（CAPD）治疗的首批50例患者的临床情况进行了研究。结果发现，CAPD能很好地控制尿毒症症状以及所研究的生化指标。高血压症状有所减轻。成本较低。对24例糖尿病患者进行了详细研究。腹腔内注射胰岛素能很好地控制糖尿病的代谢情况。对用于腹膜置管的两种导管进行了比较。由于多伦多西部医院导管在拔除时出现问题，得出结论认为Tenckhoff导管更可取。腹膜炎被发现是最严重的并发症。凝固酶阴性葡萄球菌占病例的57%。在研究期间，由对多种抗生素耐药的细菌引起的感染比例不断增加。对一种新的氨基糖苷类药物奈替米星治疗与CAPD相关的腹膜炎进行了评估。84%的病例有反应。接受治疗的19例患者中有1例出现了可逆性前庭毒性。未发现其他副作用。2例患者出现右侧胸腔积液，是腹膜透析的并发症。其中1例证实右侧膈肌缺损是并发症的原因。另一例尽管出现并发症仍继续进行CAPD治疗。
