Bistrup C, Siboni A H, Pedersen R S
Medicinsk afdeling C. Centralsygehuset i Esbjerg.
Ugeskr Laeger. 1995 Jul 10;157(28):4023-6.
A retrospective study of 51 consecutive patients treated with continuous ambulatory peritoneal dialysis (CAPD) during a total of 736 months is presented. Forty-one episodes of peritonitis were found. Thirty-three patients did not experience peritonitis. One patient had six episodes of peritonitis. The time to first and second episode of peritonitis was 487 days (16.2 months) and 1005 days (33.5 months) respectively. The incidence of peritonitis was 0.67 episodes per patient-year, and was not influenced by either sex, diabetes or previous abdominal surgery. The time to the first episode of peritonitis was equal in patients suffering from one vs two or more episodes of peritonitis. Two patients suffered from tunnel infection. Initial treatment with vancomysin and gentamycin (before knowing the results of microbiological culturing) was adequate in 90% of the peritonitis episodes. Sterile peritonitis was found in 12% of the cases. No relapse of peritonitis was observed. Six patients suffered from eleven cases of reinfection. An optimal surgical strategy as well as vancomycin plus gentamicin treatment of peritonitis are advised when a reduction in infection rates is required
本文对51例接受持续非卧床腹膜透析（CAPD）治疗达736个月的患者进行了回顾性研究。共发现41例腹膜炎发作。33例患者未发生腹膜炎。1例患者发生了6次腹膜炎发作。首次和第二次腹膜炎发作的时间分别为487天（16.2个月）和1005天（33.5个月）。腹膜炎的发生率为0.67次/患者年，且不受性别、糖尿病或既往腹部手术的影响。发生一次腹膜炎的患者与发生两次或更多次腹膜炎的患者首次发作时间相同。2例患者发生隧道感染。在90%的腹膜炎发作中，初始使用万古霉素和庆大霉素治疗（在知晓微生物培养结果之前）是足够的。12%的病例发现为无菌性腹膜炎。未观察到腹膜炎复发。6例患者发生了11例再感染。当需要降低感染率时，建议采用最佳手术策略以及用万古霉素加庆大霉素治疗腹膜炎。
