持续不卧床腹膜透析患者因梗阻性脓肾致腹膜透析相关性腹膜炎1例并文献复习  

Peritonitis secondary to obstructive pyonephrosis in a peritoneal dialysis patient:report of a case and review of the literature

作　　者：吴晓凤[1,2] 黎渐英 李剑波[1,2] 林建雄[1,2] 刘苑莹[1,2] 郭群英[1,2] WU Xiao-feng;LI Jian-ying;LI Jian-bo;LIN Jian-xiong;LIU Yuan-ying;GUO Qun-ying(Department of Nephrology,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China;NHC Key Laboratory of Clinical Nephrology(Sun Yat-sen University)and Guangdong Provincial Key Laboratory of Nephrology,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院肾内科,广州510080 [2]中山大学国家卫生健康委员会和广东省重点实验室,广州510080

出　　处：《中国血液净化》2024年第1期75-77,共3页Chinese Journal of Blood Purification

基　　金：广东省自然科学基金(2022A1515010433);广东省肾脏病重点实验室运行经费(2020B1212060028);广东省医学科研基金项目(A2019394)。

摘　　要：腹膜透析(peritoneal dialysis,PD)相关性腹膜炎通常由于接触污染或者出口处感染引起。也有少部分腹膜炎起因于肠道疾病,其中最常见的病因包括胃肠道穿孔、缺血性肠病和胆囊炎等。因梗阻性脓肾引起的腹膜炎极为罕见。该文报道了1例72岁男性腹膜透析患者因梗阻性左肾积脓引起的继发性腹膜炎,行左肾盂造瘘引流术和左肾切除术,最后未拔除腹膜透析管而继续腹膜透析治疗。随访8个月未再次发生腹膜炎。本研究报道了国内首例因梗阻性脓肾引起的持续不卧床腹膜透析合并继发性腹膜炎的病例,以提醒临床医生腹膜透析继发性腹膜炎可能的病因,为临床治疗决策提供依据。Peritoneal dialysis(PD)-associated peritonitis is usually caused by contamination of the PD system or infection of exit site.Peritonitis may sometimes be present with gastrointestinal diseases,such as intestinal perforation,ischemic bowel disease or cholecystitis.PD-associated peritonitis due to obstructive pyonephrosis is rarely seen.Here we report the first case of PD-associated peritonitis due to obstructive pyonephrosis in a 72-year-old PD patient in China.He was then subjected to a left-sided percutaneous nephrostomy and nephrectomy without removal of the peritoneal dialysis catheter.No peritonitis relapsed in the next 8 months after the operation.From this case we can draw the experience that PD-associated peritonitis may derive from a focal infection,which is of diagnostic and therapeutic importance.

关 键 词：腹膜透析 继发性腹膜炎 梗阻性肾积脓 

分 类 号：R459.5[医药卫生—治疗学]