【摘要】目的通过对3 例腹膜透析置管术围手术期腹膜透析相关性腹膜炎的病因和诊治经过的调查，探讨碘液微型盖A 与腹膜炎的相关性。方法对围手术期的腹膜炎的病因逐一排查分析。通过体外抑制细菌试验检测不同品牌碘液微型盖的抑菌效果和调查北京大学国际医院腹膜透析中心使用不同品牌碘液微型盖的患者发生腹膜炎比例、临床特点、预后，分析碘液微型盖A 与腹膜炎的相关性。结
果3 例围手术期发生腹膜炎排除了手术和腹膜透析操作及环境污染等导致的腹膜炎，怀疑与碘液微型盖A 相关。体外抑菌实验发现,3 例患者使用的A 碘液微型盖较对照碘液微型盖B、C 抑菌效果弱。更换B型碘液微型盖后腹膜炎治愈。89 例腹膜透析患者使用A 碘液微型盖发生腹膜炎的比例明显高于使用B碘液微型盖(χ2=20.578；P＜0.001)。与碘液微型盖A 的相关的腹膜炎病例特点是均无明确的诱发因素，腹膜炎的临床症状轻，腹腔透出液细菌培养均阴性，常规抗细菌感染治疗效果差。结论腹膜透析患者发生不明原因的群发腹膜炎且腹腔透出液培养阴性，除外常见原因后，需要注意腹膜透析产品质量的异常是可能造成腹膜炎的一个原因。
【Abstract】Objective To investigate the relationship between Providone-iodine minicap and peritonitis through the etiology and clinical course analyses of the 3 cases with perioperative peritoneal dialysis (PD) associated peritonitis. Methods The etiology of perioperative peritonitis was scrutinized. To analyze the relationship between the brand A of Povidone-iodine minicap and peritonitis, we compared the antibacterial effects of different brands of Povidone-iodine minicaps using in vitro bacterial inhibition tests, and investigated the incidence, clinical characteristics and prognosis of peritonitis in patients treated with different brands of
Povidone-iodine minicaps in this Peritoneal Dialysis Center. Results The possibilities of contamination during the operation of surgery operation and PD manipulation leading to the peritonitis were excluded in the 3 cases with perioperative PD associated peritonitis; the relationship between Povidone-iodine minicap and peritonitis was then suspected. In vitro bacterial inhibition tests found that the antibacterial effect of brand A was weaker than brands B and C. The peritonitis recovered after change of the Povidone-iodine minicap brand A to that of brand B. The incidence of peritonitis was higher in the patients using Povidone- iodine minicap brand A than those using that of brand B in the 89 PD patients (c2=20.578, P<0.001). The clinical peritonitis characteristics of Povidone-iodine minicap associated peritonitis were mild symptoms, negative bacterial culture of the peritoneal exudate, and poor effect of conventional antibacterial infection treatment, without other etiological factors. Conclusion It is necessary to pay attention to the abnormal quality of peritoneal dialysis products as the possible cause of peritonitis when the common causes for peritonitis have been excluded.
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