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持续性非卧床腹膜透析的首次观察(作者译)

[First observations with continuous ambulatory peritoneal dialysis (author's transl)].

作者信息

Fuchs C, Armstrong V W, Dorn D, Gröne H J, Rieger J, Scheler F

出版信息

Dtsch Med Wochenschr. 1980 Feb 29;105(9):291-6. doi: 10.1055/s-2008-1070652.

Abstract

Continuous ambulatory peritoneal diaglysis (CAPD) represents a new method for treatment of chronic renal failure whereby patients carry two litres of dialysate with them permanently and are freely mobile. Dialysis is only interrupted by exchange of dialysate in approximately 6-hourly intervals. Due to the long presence of the dialysate in the peritoneal cavity clearance values are superior to intermittent peritoneal dialysis for small-molecular substances and reach elimination values of haemofiltration for medium-molecular substances. The main technical requirements consist of a permanent peritoneal dialysis catheter linked to a plastic dialysate bag by way of a connecting tube. In order to avoid frequent change of bag and thus increased risk of peritonitis bags are folded and carried on the body of the patient during the interval. Thereafter the bag is unfolded, filled with used dialysate and exchanged for a new bag. Six patients were thus treated for over 34 patient-months so far. Changes of chemical pathology were readily acceptable. Even though CAPD has several advantages over conventional dialysis as they are mainly founded on the high degree of rehabilitation of patients, risk of peritonitis is still a considerable factor of uncertainty.

摘要

持续性非卧床腹膜透析(CAPD)是一种治疗慢性肾衰竭的新方法,患者可随身携带两升透析液,行动自如。透析仅每隔约6小时更换透析液时中断。由于透析液在腹腔内停留时间长,小分子物质的清除值优于间歇性腹膜透析,中分子物质的清除值达到血液滤过的清除值。主要技术要求包括一根永久性腹膜透析导管,通过连接管与一个塑料透析液袋相连。为避免频繁更换透析液袋从而增加腹膜炎风险,透析液袋在间隔期折叠后挂在患者身上。之后将透析液袋展开,装满用过的透析液,再换一个新的透析液袋。到目前为止,已有6名患者接受了超过34个患者月的治疗。化学病理学变化易于接受。尽管CAPD比传统透析有几个优点,主要基于患者的高康复程度,但腹膜炎风险仍是一个相当大的不确定因素。

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