中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (09): 607-610.doi: 10.3969/j.issn.1671-4091.2019.09.007

• 临床研究 • 上一篇    下一篇

腹膜透析患者换液操作前准备情况与腹膜炎发生的相关性分析

林小燕1, 林建雄1, 朱丽娜1,昌瑶1, 杨睿1,毛海萍1, 阳晓1   

  1. 1. 中山大学附属第一医院肾内科腹膜透析中心
  • 收稿日期:2019-04-08 修回日期:2019-05-21 出版日期:2019-09-12 发布日期:2019-09-02
  • 通讯作者: 林建雄jianxionglinsysu@126.com E-mail:jianxionglinsysu@126.com
  • 基金资助:
    广州市科技计划:自体移植腹膜间皮细胞对腹膜纤维化的防治作用(201704020167)

The correlation between preparation before fluid exchange and peritoneal dialysis- related peritonitis

  1. 1Center for Peritoneal Dialysis, Department of Nephrology, The First affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2019-04-08 Revised:2019-05-21 Online:2019-09-12 Published:2019-09-02

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摘要： 【摘要】目的探讨腹膜透析患者换液操作前准备情况及其与腹膜炎发生的相关性。方法回顾性分析2018 年7～12 月在中山大学附属第一医院肾内科腹膜透析中心规律返院随访腹膜透析患者的换液操作前准备情况。自行设计问卷调查患者操作前准备情况并收集患者临床资料等。结果纳入336 例腹膜透析患者，环境准备依从者为215 例(64.0%)，物品准备依从者295 例(87.8%)，人员准备依从
者172 例(51.2%)，换液操作者是否接受换液操作培训与考核者328 例(97.6%)。74 例(22.0%)腹膜透析患者发生127 例次腹膜透析相关腹膜炎，发生率为0.10 次/患者年。Cox 回归分析显示：环境准备不依从，人员准备不依从和换液操作者未接受培训考核是腹膜炎发生的独立危险因素(HR 值分别为1.659, 1.792,4.929；P 值分别为0.037，0.019，0.001)。结论腹膜透析患者换液操作前的环境准备不依从、人员准备不依从和换液操作者未接受过培训考核与较高的腹膜炎发生率独立相关。

关键词: 腹膜透析, 腹膜炎, 换液操作前准备

Abstract:

【Abstract】Objective This study was to explore the correlation between preparation before peritoneal dialysis (PD) fluid exchange and PD-related peritonitis. Methods PD patients who were regularly followed up between July and December, 2018 in our PD center were enrolled in this retrospective study. A questionnaire for the preparation conditions before fluid exchange was designed by our PD nurses. Demographic and clinical data and episodes of peritonitis were collected. Results A total of 336 PD patients were enrolled in this study. There were 215 (64.0%) patients compliant with environmental preparation, 295 (87.8%)
patients compliant with material preparation, and 172 (51.2%) patients compliant with manipulator preparation. A total of 127 episodes of peritonitis happened in 74 (22.0%) patients, with the peritonitis rate of 0.10 episodes per patient year. Cox regression analysis showed that non-compliance with environmental preparation (HR=1.659, P=0.037) and manipulator preparation (HR=1.792, P=0.019), and the manipulator not having standard training (HR=4.929, P=0.001) were the independent risk factors for peritonitis. Conclusion Non-compliance with environmental and manipulator preparations, and the manipulator not having standard training were independently associated with PD-related peritonitis.

Key words: Peritoneal dialysis, Peritonitis, Preparation before fluid exchange

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