摘要
目的探讨早发性腹膜透析相关性腹膜炎影响因素及防控策略。方法选取华中科技大学同济医学院附属同济医院2018年1月至2020年12月行腹膜透析的268例病人,采取回顾性研究对早发性腹膜透析相关性腹膜炎的危险因素进行分析,同时探讨腹膜透析相关性腹膜炎的相关防控策略。结果268例腹膜透析的病人中有早发性腹膜炎的52例,分离出病原菌共47株,其中革兰阳性菌占比55.32%(26/47),以表皮葡萄球菌为主,革兰阴性菌占比29.79%(14/47),以大肠埃希菌为主,真菌占比14.89%(7/47),以光滑假丝酵母菌为主。单因素分析显示文化程度小学及以下(χ^(2)=21.82,P<0.001)、血钾低(χ^(2)=5.25,P=0.023)、血清前白蛋白低(χ^(2)=82.61,P<0.001)、白蛋白低(χ^(2)=84.27,P<0.001)及隧道口感染(χ^(2)=40.46,P<0.001)差异有统计学意义。通过多因素logistic回归分析显示文化程度低[OR=9.90,95%CI:(3.66,26.83),P<0.001]、血清前白蛋白低[OR=9.76,95%CI:(3.06,31.11),P<0.001]、血清白蛋白低[OR=3.34,95%CI:(1.15,9.68),P=0.027]及隧道口感染[OR=12.83,95%CI:(3.13,52.60),P<0.001]为早发性腹膜透析相关性腹膜炎的危险因素。结论文化程度低、血清前白蛋白低、血清白蛋白低及隧道口感染为早发性腹膜透析相关性腹膜炎独立的危险因素,对于文化程度低的病人强化操作过程的培训、及时改善病人的营养状态、定期对隧道口进行维护,可以预防早发性腹膜透析相关性腹膜炎的发生。
Objective To investigate the risk factors and preventive strategies for early-onset peritonitis in peritoneal dialysis patients.Methods A total of 268 patients who underwent peritoneal dialysis in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2018 to December 2020 were enrolled in the study.A retrospective study was conducted to analyze the risk factors and preventive strategies for early-onset peritonitis in peritoneal dialysis patients.Results Among the 268 cases of peritoneal dialysis patients,52 cases had early-onset peritonitis.Totally 47 strains of pathogens were isolated,55.32%(26/47)of which were gram-positive bacteria,mainly Staphylococcus epidermidis,29.79%(14/47)were gram-negative bacteria,mainly Escherichia coli,and 14.89%(7/47)were fungi,mainly Candida glabrata.Univariate analysis results showed that statistically significant differences were found in primary school educational background and lower(χ^(2)=21.82,P<0.001),lower serum potassium level(χ^(2)=5.25,P=0.023),lower serum prealbumin level(χ^(2)=82.61,P<0.001),lower albumin level(χ^(2)=84.27,P<0.001)and catheter exit-site infection(χ^(2)=40.46,P<0.001).Multivariate logistic regression analysis results showed that lower education level[OR=9.90,95%CI:(3.66,26.83),P<0.001],lower serum prealbumin level[OR=9.76,95%CI:(3.06,31.11),P<0.001],lower serum albumin level[OR=3.34,95%CI:(1.15,9.68),P=0.027]and catheter exit-site infection[OR=12.83,95%CI:(3.13,52.60),P<0.001]were risk factors for early-onset peritonitis in peritoneal dialysis patients.Conclusions Lower education level,lower serum prealbumin,lower serum albumin level and catheter exit-site infection were independent risk factors for early-onset peritonitis in peritoneal dialysis patients.For patients with lower education level,it is necessary to strengthen the training of the operation process,take measures to improve the nutritional status of malnourished patients and disinfect the catheter exit-site regularly,which can
作者
吕倩
赖晓全
徐敏
陈茜
LYU Qian;LAI Xiaoquan;XU Min;CHEN Xi(Department of Hospital Infection Control,Tongji Hospital,Tongji Medical College,Huazhong Uni-versity of Science and Technology,Wuhan,Hubei 430030,China)
出处
《安徽医药》
CAS
2022年第10期1940-1943,共4页
Anhui Medical and Pharmaceutical Journal
基金
国家自然科学基金项目(71974062)
湖北省自然科学基金项目(2019CFB112)。
