总结15例腹膜透析合并胸腹瘘行膈肌修补术患者的早期识别及围手术期护理经验。针对腹膜透析患者发生胸腹瘘易被忽视，术后护理不当易出现复发、肺不张等问题，采取术前胸腹瘘的精准分层管理与早期识别、多学科协作制订围手术期护理方案；术后实施小剂量渐进式递增透析方案、胸腔闭式引流与七步运动功能锻炼协同的肺康复等护理措施。经过精心治疗和护理，15例均康复出院，随访3~48个月，均未再次发生胸腹瘘，规律行腹膜透析治疗。

To summarize the early identification and perioperative nursing experience of 15 patients with peritoneal dialysis complicated with pleuroperitoneal communication undergoing diaphragmatic repair. For peritoneal dialysis patients，the occurrence of pleuroperitoneal communication is easily overlooked，and improper postoperative nursing can lead to recurrence，atelectasis，and other issues. To address these issues，preoperative precise stratified management and early identification of pleuroperitoneal communication was taken，and perioperative nursing plan was developed by multidisciplinary cooperation. After operation，the nursing measures such as small dose progressive dialysis program，closed thoracic drainage and seven-step functional exercise coordinated lung rehabilitation were implemented. After careful treatment and nursing，15 patients recovered and were discharged. During the follow-up of 3 to 48 months，15 patients didn’t have pleuroperitoneal communication again，and they were treated with peritoneal dialysis regularly.