CAJ | 학술논문

腹膜炎是腹膜透析首要的并发症.以往均强调腹膜炎发生后的治疗,近年来随着对腹膜透析相关腹膜炎发生病因的研究,更加意识到预防腹膜炎的重要性.只有尽早纠正危险因素,减少腹膜炎的发生,才能更好保护腹膜功能.腹膜炎发生的重要原因有污染、外出口和隧道感染形成的导管相关细菌生物膜、营养不良.低清蛋白血症是腹膜炎的高危因素.维生素D(VitD)的补充可调节免疫功能,是降低感染风险的新思路;肠源性腹膜炎(经肠道感染导致的内源性微生物相关腹膜炎)的发病率高,技术失败率更高.降低肠菌移位的风险、调节肠道菌群、采取长程抑菌治疗是重要的治疗方法.粪菌移植是未来研究的方向.现就这些问题的发生及如何进行预防进行概述.
복막염시복막투석수요적병발증.이왕균강조복막염발생후적치료,근년래수착대복막투석상관복막염발생병인적연구,경가의식도예방복막염적중요성.지유진조규정위험인소,감소복막염적발생,재능경호보호복막공능.복막염발생적중요원인유오염、외출구화수도감염형성적도관상관세균생물막、영양불량.저청단백혈증시복막염적고위인소.유생소D(VitD)적보충가조절면역공능,시강저감염풍험적신사로;장원성복막염(경장도감염도치적내원성미생물상관복막염)적발병솔고,기술실패솔경고.강저장균이위적풍험、조절장도균군、채취장정억균치료시중요적치료방법.분균이식시미래연구적방향.현취저사문제적발생급여하진행예방진행개술.
Peritonitis is a primary complication of peritoneal dialysis.In the past concentration was the treatment after peritonitis became evident.With the study of the causes of peritonitis, it becomes evident that, in order to better protect the peritoneal function, more focus should be on the prevention of peritoneal dialysis-related peritonitis, correction as soon as possible the risk factors of peritonitis, and the reduction of the incidence of peritonitis.The main causes of peritonitis include pollution, outlet exports and catheter-related infections bacterial biofilm formation tunnel.Emphasis should be on the occurrence of malnutrition.Albumin levels are risk factors for peritonitis.To reduce the risk of infection new ideas include VitD supplements that regulate immune function.Endogenous microbes associated peritonitis caused by intestinal infections.Future research directions should focus on reducing the risk of intestinal bacteria translocation, regulating intestinal flora, taking a long-range antimicrobial therapy during the critical period, and implementing fecal bacteria transplant.This paper gives an overview of these issues and how to prevent their occurrence.