Rubin J, Rogers W A, Taylor H M, Everett E D, Prowant B F, Fruto L V, Nolph K D
Ann Intern Med. 1980 Jan;92(1):7-13. doi: 10.7326/0003-4819-92-1-7.
We initiated a therapeutic program of continuous ambulatory peritoneal dialysis for patients with chronic renal failure. Our program resulted in many episodes of peritonitis arising from contamination due to the technical aspects of the procedure. Microbiologic evaluation showed that 73% of 97 episodes were culture positive, with gram-positive organisms causing most of the cases, especially early in dialysis. Gram-negative rods tended to occur later. Gram stains of dialysate effluent resulted in a disappointingly low yield of only 9% positivity. Cell counts were a dependable indicator of the presence of peritoneal inflammation and also of therapeutic success. Most patients responded well to intraperitoneal cephalothin, 125 mg/L for 10 to 14 d. The occurrence of peritonitis resulted in 0.93 years of hospitalization during the total of 15.45 patient-years on dialysis, which essentially negated the financial advantages of this method of treatment of chronic renal failure. For this to be a successful mode of therapy, advances in the prevention of peritonitis must be made.
我们为慢性肾衰竭患者启动了一项持续性非卧床腹膜透析治疗方案。我们的方案因操作技术方面的污染导致了许多腹膜炎发作。微生物学评估显示，97次发作中有73%培养呈阳性，革兰氏阳性菌导致了大多数病例，尤其是在透析早期。革兰氏阴性杆菌往往在后期出现。透析液流出物的革兰氏染色阳性率低至9%，令人失望。细胞计数是腹膜炎症存在以及治疗成功的可靠指标。大多数患者对腹腔内注射头孢噻吩（125mg/L，持续10至14天）反应良好。在总计15.45患者年的透析期间，腹膜炎的发生导致了0.93年的住院时间，这基本上抵消了这种慢性肾衰竭治疗方法的经济优势。要使这种治疗方式取得成功，必须在预防腹膜炎方面取得进展。
