摘要
目的 探讨3种不同腹膜透析液采集法对腹膜透析相关性腹膜炎（PDAP）致病菌培养的影响,为基层医院推广使用简单有效的腹膜透析液采集方法提供临床依据.方法 采用便利抽样法,选取2016年6月—2017年7月树兰（杭州）医院肾内科收治的32例PDAP患者为研究对象,共采集43例次腹膜炎透析液标本.分别采用常规法、改良法和离心法收集同一份腹膜透析液行细菌培养,比较3种采集方法对透析液致病菌培养的阳性率、致病菌分布和培养报告时间的影响.结果 常规法培养致病菌阳性率为53.5%,改良法为76.7%,离心法为83.7%;与常规法相比,改良法、离心法致病菌培养的阳性率均提高,差异有统计学意义（P〈0.05）,而改良法与离心法比较差异无统计学意义（P〉0.05）.3种采集法的前3位主要致病菌均为表皮葡萄球菌、大肠埃希菌和金黄色葡萄球菌.与常规法相比,改良法和离心法提高了透析液革兰阴性菌的阳性检出率,差异均有统计学意义（P〈0.05）,但革兰阳性菌培养的阳性率与常规法相比差异均无统计学意义（P〉0.05）.常规法致病菌培养平均报告时间长于改良法和离心法,差异均有统计学意义（P〈0.05）.结论 与常规法致病菌培养比较,改良法和离心法均能提高PDAP患者腹膜炎致病菌培养的阳性率,特别是革兰阴性菌,并且具有快速检出的优点,可为早期治疗腹膜炎提供临床指导.相比离心法,改良法简单易行,更值得在基层医院推广使用.
Objective To evaluate three different peritoneal dialysis fluid collection methods for pathogenic bacteria culture in peritonitis dialysis-associated peritonitis （PDAP）, and provide clinical basis for the use of simple and effective peritoneal dialysis fluid collection method in primary hospital. Methods A total of 32 cases of PDAP patients treated in Shulan （Hangzhou） Hospital from June 2016 to July 2017 were included in the study using convenient sampling method. A number of 43 peritoneal dialysis fluid specimens were collected respectively using the traditional method, modified method and centrifugal method, and then were cultured for bacterial identification. Positive rate of bacteria, distribution of bacterial pathogens and reported time were compared among three groups. Results The positive rate of pathogenic bacteria showed that traditional method was 53.5%, modified method was 76.7% and centrifugal method was 83.7%. Compared with the traditional method, the positive rate of modified method and centrifugal method increased significantly （P〈0.05）. However, there was no statistical difference between the modified method and centrifugal method （P〉 0.05）. Three main species were epidermis staphylococcus, escherichia coli and staphylococcus aureus in three collection methods. In the modified method and centrifugal method, the positive rate of gram negative bacteria were higher than the traditional method （P〈0.05）; but there was no obvious difference on the positive rate of gram positive bacteria culture （P〉0.05）. The average reporting time of traditional culture was longer than the modified method and centrifugal method （P〈 0.05）. Conclusions Compared with traditional collection method, both modified method and centrifugal method could increase positive rate of bacteria culture in PDAP patients, especially gram negative bacteria, and had the advantage of rapid detection, which could provide clinical guidance for early treatment of peritonitis. Compared with centrifugal meth
作者
徐妙娟
朱倩文
王可瑞
Xu Miaojuan;Zhu Qianwen;Wang Kerui(Department of Nephrology, Shulan （Hangzhou） Hospital （Zhefiang University International Hospital）, Hangzhou 310006, China)
出处
《中华现代护理杂志》
2018年第10期1195-1198,共4页
Chinese Journal of Modern Nursing
关键词
腹膜透析
腹膜炎
致病菌
细菌培养
阳性率
Peritoneal dialysis
Peritonitis
Pathogenic bacteria
Bacterial culture
Positive rate
