- 期刊
Tuberculous Peritonitis in a Child Undergoing Continuous Ambulatory Peritoneal Dialysis
尿毒兒童於CAPD治療中發生的結核菌性腹膜炎
摘要
本文報告一例13歲罹患Arnoed-Chiari徵候群之女童，因神經性膀胱病變合併輸尿管內尿逆流，發生尿毒症，而開始CAPD治療。13個月後引流出的腹膜透析液突然轉呈混濁，患者出現發燒、腹痛症狀，流出之透析液中白血球數為1,400/mm^3，其中96%為多核球，患者接受三天vancomycin及netilmicin治療後，症狀豪無改善，而其流出透析液之所有微生物檢查均呈陰性，同時我們發現其同住之祖父罹患肺結核，於是停止其抗生素治療，而改以一劑鏈徽素腹膜內注射及口服抗結核菌藥物，兩度發現結核菌，患者之上述症狀於三天內全部消失，於發病頭一週內，其腹膜呈高通透性，而喪失脫水功能，我們以自動換液機做多次快速換液，爾後回到標準的CAPD治療，追蹤至今16個月，患者腹膜功能良好。
並列摘要
Abstract. We present a 13-year-old girl with Arnold-Chiari syndrome and uremia secondary to neurogenic bladder. She had been treated with continuous ambulatory peritoneal dialysis (CAPD) for 13 months prior to the development of peritonitis. The patient demonstrated no improvement with a 3-day therapy of intraperitoneal vancomycin and netilmicin. Meanwhile, smear of centrifuged dialysate revealed acid fast bacilli on two occasions. We, then, Started anti-TB therapy with oral isoniazid (INAH), rifampin and ethambutal. The symptoms subsided within three days. In the first week, the patient lost her peritoneal ultrafiltration and needed daytime automatic peritoneal dialysis. At the last follow-up examination, 12 months after treatment, she remained well on standard CAPD.
延伸閱讀
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