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维持性腹膜透析腹膜炎并发肠梗阻的临床特点

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【作者】 刘红王华陈洪宇童孟立

【通讯作者】 童孟立;

【机构】 杭州市中医院

【摘要】 目的 了解腹膜透析相关性腹膜炎并发肠梗阻的临床特点,为腹膜炎合并肠梗阻的防治提供依据。方法 回顾性分析2013年1月至2017年12月期间13例腹膜透析相关性腹膜炎合并肠梗阻患者的临床资料,并以同时期住院的13例单纯腹膜透析相关性腹膜炎患者作为对照,对两组患者的年龄、性别、透析龄、化验指标及预后转归等进行统计分析。结果 两组患者年龄、性别、透析龄等无明显差异,但腹膜炎合并肠梗阻组患者致病菌多为肠源性细菌,其血浆白蛋白、血钾水平明显低于单纯腹膜炎组,超敏C反应蛋白明显高于单纯腹膜炎组,其治疗失败率明显高于单纯腹膜炎组。结论 腹膜透析相关性腹膜炎致病菌为肠源性细菌且合并高炎症状态、明显低蛋白血症和低钾血症时需警惕肠梗阻的发生,应早期发现,及时治疗。

【Abstract】 Objective To investigate the clinical features of peritoneal dialysis related peritonitis complicated with intestinal obstruction,and provide evidence for the prevention and treatment of peritonitis with intestinal obstruction.Methods 13 patients with peritoneal dialysis related peritonitis complicated by intestinal obstruction were recruited from January 2013 to December 2013,and 13 patients without intestinal obstruction as the control group.Their age,gender,time of dialysis,laboratory data and outcomes were analyzed.Results There was no significant difference between the two groups in age,gender,and time of dialysis,but the pathogenic bacteria of peritoneal dialysis associated peritonitis with intestinal obstruction were mostly enterogenous bacteria,the blood albumin levels and the potassium levels were significantly lower in the intestinal obstruction group,and the hypersensitive c-reactive protein was significantly higher than pure peritonitis group,and the treatment failure rate was significantly higher in the intestinal obstruction group.Conclusion The pathogenic bacteria of peritoneal dialysis-related peritonitis are enterogenous bacteria,which are complicated with hyperinflammation,marked hypoproteinemia and hypokalemia.

【关键词】 腹膜透析腹膜炎肠梗阻
【Key words】 Peritoneal dialysisPeritonitisIntestinal obstruction
【基金】 浙江省卫计委课题项目(2016KYB236)
  • 【文献出处】 浙江临床医学 ,Zhejiang Clinical Medical Journal , 编辑部邮箱 ,2019年10期
  • 【分类号】R574.2;R692.5;R572.2
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