摘要
目的分析老年腹膜透析相关性腹膜炎致病菌的分布和预后特点,以指导临床采取有效预防措施。方法回顾性分析2009年1月1日至2017年12月31日期间南京医科大学附属苏州医院肾内科收治的72例次腹膜透析相关性腹膜炎患者的临床资料;根据年龄分为老年组(≥65岁)和中青年组(<65岁),将老年组患者的基本临床特点、致病菌分布以及预后情况与中青年组相比较。采用Kaplan-Meier法计算患者生存率和技术生存率。结果 43例患者(老年组22例,中青年组21例)发生72例次腹膜透析相关性腹膜炎(老年组38例次,中青年组34例次),共培养出58株致病菌,老年组31株(包括G^+菌19株,G^-菌11株,真菌1株);中青年组27株(包括G^+菌19株,G^-菌5株,真菌3株)。老年组的主要致病菌为G^+菌(61. 29%)。老年组的表皮葡萄球菌的发生率显著高于中青年组(29. 03%与3. 70%,P=0. 028)。老年组G^-菌和真菌的发生率与中青年组相比,差异无统计学意义。老年组腹膜炎的治疗转归(治愈率、拔管率、死亡率)与中青年组差异无统计学意义(P=0. 265,P=0. 066,P=0. 279)。Kaplan-Meier分析显示老年组的总体生存率并不低于中青年组(P=0. 282),而老年组的技术生存率显著高于中青年组(P=0. 007)。结论老年腹膜透析相关性腹膜炎患者的致病菌分布与中青年患者有所不同,与他们更容易出现接触污染有关。老年腹膜透析相关性腹膜炎患者的总体预后并不比中青年患者差。
Objective To analyze the distribution of pathogens and prognosis in elderly patients with peritoneal dialysis-related peritonitis in our hospital so as to guide clinical preventive measures.Methods A retrospective analysis was made with clinical data of 72 patients with peritoneal dialysis-related peritonitis admitted to the Department of Nephrology,Suzhou Hospital Affiliated to Nanjing Medical University(Suzhou Municipal Hospital)from January 1,2009 to December 31,2017.According to the age,the patients were divided into the elderly group(≥65 years old)and the young-middle-aged group(<65 years old),which were compared in the basic clinical characteristics,pathogen distribution,and prognosis.Patient survival and technical survival were calculated with the Kaplan-Meier method.Results Forty-three patients(22 from the elderly group,and 21 from the young-middle-aged group)had 72 occurrences of peritoneal dialysis-related peritonitis(38 occurrences in the elderly group,and 34 occurrences in the young-middle-aged group).A total of 58 strains of pathogenic bacteria were found from culture,with 31 strains from the elderly group(including 19 strains of G^+,11 strains of G^-bacteria,and 1 strain of fungus),and 27 strains from the young-middle-aged group(including 19 strains of G^+,5 strains of G^-bacteria,and 3 strains of fungi).The main pathogens in the elderly group were G^+bacteria(61.29%).The incidence of Staphylococcus epidermidis in the elderly group was significantly higher than that in the young-middle-aged group(29.03%vs 3.70%,P=0.028).The incidences of G^-bacteria and fungi in the elderly group were not significantly different from those in the young-middle-aged group.There were no significant differences in the treatment outcomes(cure rate,extubation rate,and mortality)between the elderly group and the young-middle-aged group(P=0.265,P=0.066,P=0.279).Kaplan-Meier analysis showed that the overall survival rate of the elderly group was not lower than that of the young-middle-aged group(P=0.282),while the technica
作者
汤立
沈平
胡钦凤
柴华旗
Tang Li;Shen Ping;Hu Qinfeng;Chai Huaqi(Department of Nephrology,Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital),Suzhou 215002,Jiangsu Province,China)
出处
《中华肾病研究电子杂志》
2018年第5期211-216,共6页
Chinese Journal of Kidney Disease Investigation（Electronic Edition）
关键词
腹膜透析相关性腹膜炎
老年患者
致病菌
预后
Peritoneal dialysis-related peritonitis
Elderly patients
Pathogens
Prognosis
