Wanten G J, Koolen M I, van Liebergen F J, Jansen J L, Wever J
Department of Internal Medicine, Bosch Medicentrum, Hertogenbosch, Netherlands.
Neth J Med. 1996 Jul;49(1):4-12. doi: 10.1016/0300-2977(96)00009-5.
To evaluate outcome and complications in patients treated with CAPD at our centre a retrospective study was performed.
Relevant data from all 123 consecutive patients on the CAPD program from 1982 to 1994 were reviewed.
Patient survival after 1, 2, 3 years was 89, 78, 69 and 50% respectively. The probability of having a functioning catheter after 1, 2, 3 and 5 years was 90, 77 and 68%, respectively. We observed 179 technical complications (42 intra-abdominal pressure, 137 catheter-related). Peritonitis (220 episodes, 62% gram-positive) occurred with a mean incidence of 1 episode in 13 treatment months and was the main reason (26 cases, 68% gram-positive) for catheter removal. (Mixed) Gram-negative peritonitis was associated with a higher mortality, and relatively more often resulted in termination of CAPD treatment when compared to gram-positive peritonitis. Introduction in 1988 of a new fluid exchange system (Twin Bag) and alcohol disinfection of hands was accompanied by a decreased incidence of peritonitis and exit-site infections, but to date patient, technique and catheter survival have not improved.
Although therapeutic measures have resulted in a reduced incidence of peritonitis and exit-site infections, infectious and technical complications remain a serious threat to patient and technique survival in CAPD treatment.
为评估在我们中心接受持续性非卧床腹膜透析（CAPD）治疗患者的治疗结果及并发症，进行了一项回顾性研究。
回顾了1982年至1994年期间连续接受CAPD治疗的123例患者的相关数据。
1年、2年、3年和5年后患者的生存率分别为89%、78%、69%和50%。1年、2年、3年和5年后腹透管仍有功能的概率分别为90%、77%和68%。我们观察到179例技术并发症（42例腹腔内压力相关，137例导管相关）。腹膜炎（220次发作，62%为革兰氏阳性菌感染）平均每13个治疗月发作1次，是拔除腹透管的主要原因（26例，68%为革兰氏阳性菌感染）。（混合性）革兰氏阴性菌腹膜炎与较高的死亡率相关，与革兰氏阳性菌腹膜炎相比，相对更常导致CAPD治疗终止。1988年引入新的液体交换系统（双袋系统）并采用酒精洗手消毒后，腹膜炎和出口处感染的发生率有所下降，但迄今为止，患者、技术和导管的生存率并未提高。
尽管治疗措施已使腹膜炎和出口处感染的发生率降低，但感染性和技术性并发症仍然严重威胁着CAPD治疗中患者的生存及技术的存续。
