Rubin J, Ray R, Barnes T, Teal N, Hellems E, Humphries J, Bower J D
Am J Kidney Dis. 1983 May;2(6):602-9. doi: 10.1016/s0272-6386(83)80039-0.
Peritonitis is the most important complication of continuous ambulatory peritoneal dialysis (CAPD). We reviewed our experience with peritonitis over a 2 1/2-year period. Our patients spent 4% of their total time on dialysis in hospital due to peritonitis. Thirty-eight percent of the episodes of peritonitis were treated without hospitalization. We evaluated the dialysate bag change technique as commonly performed with currently available devices (extension tubing and titanium Luerlock Tenckhoff catheter adapter). The aseptic techniques described for dialysis extension tubing changes appear adequate (with no increased incidence of peritonitis demonstrated shortly after an extension tubing set change). Long-term sterility is maintained at the dialysate bag puncture port and at the orifice of the dialysis catheter adapter (no positive cultures from the bag port and orifice of the titanium adapter). Etiologic diagnosis of uremia was not a risk factor predisposing to peritonitis. The incidence of peritonitis was greater among patients with less formal education and lower income. Out data suggest that patients with less formal education and of lower economic status be carefully evaluated before commencing CAPD.
腹膜炎是持续性非卧床腹膜透析（CAPD）最重要的并发症。我们回顾了2年半时间里我们在腹膜炎治疗方面的经验。我们的患者因腹膜炎在医院接受透析的时间占总透析时间的4%。38%的腹膜炎发作无需住院治疗。我们评估了使用现有设备（延长管和钛制鲁尔锁Tenckhoff导管接头）进行的透析液袋更换技术。所描述的透析延长管更换无菌技术似乎是充分的（延长管套件更换后不久腹膜炎发生率未见增加）。透析液袋穿刺口和透析导管接头孔保持长期无菌（钛制接头的袋口和孔未培养出阳性菌）。尿毒症的病因诊断不是易患腹膜炎的危险因素。受教育程度较低和收入较低的患者腹膜炎发生率更高。我们的数据表明，在开始CAPD之前，应对受教育程度较低和经济状况较差的患者进行仔细评估。
