- 期刊
Continuous Ambulatory Peritoneal Dialysis Complicating with Abdominal Hernias in Children
兒童連續性可攜帶式腹膜透析併發的腹部疝氣
摘要
自1991年5月至1995年10月，本文共收集了10位接受連續可投保帶式腹膜 透析(CAPD)的尿毒症兒童，他（她）們的植管年齡分布爲3.6歲至14.4歲，一共經歷13條導管植入。患者於術前均已有無疝氣存在，植管手術於全身麻醉之下進行，術後10天開始透析，平均腹膜透析液用量爲每次每公觔體重32.3ml，這些腹膜透析導管的追蹤期間平均爲17個月。其中5條導管（計4位病人）髮生了8個腹部疝氣，佔38.5%，包括3個腹股溝疝氣，3個臍疝氣、一個臍上疝氣及一個導管植入處疝氣，其中6個疝氣接受手術修補，然而有2個病人於手術後再發生疝氣，因此由原來標准的CAPD治療法改成自動腹膜透析。我們分析其因素對疝氣産生的影響，發現男性及六歲以下幼兒，有較高之疝氣發生率（但未達統計上有意義之差別）。由於接受CAPD治療中的兒童發生腹部疝氣的機率並不少，而且若不處理將愈來愈大，甚至發生併發症，幫我們建議應盡早施行手術治療。
並列摘要
From May 1991 through December 1995, 10 uremic children ranging in age from 3.6 years old to 14.4 years old underwent insertion of 13 peritoneal dialysis catheters for continuous ambulatory peritoneal dialysis (CAPD). Eight abdominal hernias developed, associated with five catheters (38.5%) in four of the patients. Three hernias were inguinal, three were umbilical, one was epigastric, and one occurred at the catheter insertion site. Six hernias, including one umbilical hernia developing incarceration, were repaired. After operations because of recurrent hernias, two patients were switched from standard CAPD to night intermittent PD (NIPD) using low volumes of dialysate. Male sex and age younger than six years were possible associated risk factors (P=0.19). In conclusion, hernia in young children undergoing CAPD is not unusual, and early surgical repair is advisable to avoid complications.
延伸閱讀
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