关键词: 腹膜透析, 包裹性腹膜硬化症, 纤维化, 肠梗阻

Abstract: Encapsulating Peritoneal Sclerosis (EPS) is a rare but serious complication of peritoneal dialysis (PD). Its primary pathological feature is diffuse peritoneal fibrosis with the formation of a dense, constricting fibrous capsule that envelops the intestines, leading to intestinal obstruction and malnutrition. The pathogenesis of EPS remains unclear, with the "two⁃hit hypothesis" being the most widely accepted theory. Common risk factors include prolonged duration of PD, recurrent episodes of PD⁃associated peritonitis, long⁃term exposure to hyperosmotic and high⁃glucose dialysis solutions, and abrupt discontinuation of PD. The early stages of the disease lack specific clinical manifestations, and diagnosis requires a combination of clinical symptoms and imaging evaluation. Among imaging modalities, computed tomography (CT) is particularly valuable for detecting peritoneal thickening, calcification, and encasement of intestinal loops. Management involves a multidisciplinary approach, including cessation of PD, intensified nutritional support, appropriate use of anti⁃inflammatory and anti⁃fibrotic medications, and surgical intervention when clearly indicated. This article comprehensively reviews the epidemiology, pathogenesis, diagnosis, and treatment advances in EPS based on the latest research developments, aiming to offer insights for clinical decision⁃making.

Key words: peritoneal dialysis, encapsulating peritoneal sclerosis, fibrosis, intestinal obstruction