腹膜透析非感染性合併症

Non-infective Complications of Peritoneal Dialysis

腹膜透析在腹膜炎感染率逐年下降時，非感染性併發症卻逐年增加。非感染性併發症可分為機械性和代謝性二種，造成非感染性併發症增加的原因是因腹膜透析導管留置腹腔、腹內壓增加、以及葡萄糖透析液及其代謝產物的影響所致。因此為了延長腹膜透析導管使用年限以及降低非感染性併發症，臨床上應著重預防策略，包括腹膜透析團隊的臨床專業知識、植管前審慎評估、外科醫師的植管技巧以及給予病人教育和心理社會支持，並使用生物相容性高的透析液等，以延長腹膜透析治療年限，提高病人生活品質。

As the rate of peritoneal dialysis peritonitis decline over the years, non-infective complications of peritoneal dialysis gradually increase. Non-infective complications of peritoneal dialysis can be classified into mechanical and metabolic. Increased in non-infective complications of peritoneal dialysis are due to indwelling peritoneal catheter, increased intraperitoneal pressure and dextrose containing dialysate and its metabolites. Clinically, we need to focus on preventive strategies in order to prolong the lifespan of peritoneal dialysis catheter and lower the complications of noninfectious complications. The strategies should cover clinical knowledge of the peritoneal dialysis caring team, assessment in catheter implantation, surgeons’ skill in implantation and providing psychosocial support for the patients, and the use of biocompatible dialysate in order to prolong peritoneal dialysis treatment years and to improve quality of life for the patients.