中国血液净化

中国血液净化 ›› 2022, Vol. 21 ›› Issue (06): 461-464.doi: 10.3969/j.issn.1671-4091.2022.06.018

• 护理研究 • 上一篇    下一篇

出口处护理操作者对老年腹膜透析患者导管出口处感染的影响#br#

鲁树超    吕 珊    于晓丽   阳 晓     林建雄   

  1. 中山大学附属第一医院 1肾内科 2卫生部重点实验室
  • 收稿日期:2021-09-09 修回日期:2021-11-06 出版日期:2022-06-12 发布日期:2022-06-12
  • 通讯作者: 林建雄 ljianx@mail.sysu.edu.cn E-mail:ljianx@mail.sysu.edu.cn
  • 基金资助:
    国家自然科学基金;国家重点研发项目;广东省重点实验室运行经费;广东省科技计划;广州市科技计划项目

Effect of caregiver on catheter exit-site infection in elderly peritoneal dialysis patients 

  • Received:2021-09-09 Revised:2021-11-06 Online:2022-06-12 Published:2022-06-12
  • Contact: LIN Jian-xiong ljianx@mail.sysu.edu.cn E-mail:ljianx@mail.sysu.edu.cn
  • Supported by:
    Natural Science Foundation of China;the National Key R&D Program of China;Operational Grant of Guangdong Provincial Key Laboratory;Guangdong Provincial Programme of Science and Technology;Guangzhou Programme of Science and Technology

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摘要： 探讨出口处护理操作者对老年腹膜透析患者导管出口处感染的影响。 方法  收集2009年1月～2012年12月在中山大学附属第一医院肾内科腹膜透析中心置管的年龄≥60岁的腹膜透析患者的相关资料。 结果 213例老年腹膜透析患者纳入本研究。28例(13.1%)腹膜透析患者发生30例次出口处感染，出口处感染率为80.9患者月(0.15次/患者年)。出口处护理操作者评估结果显示：平均年龄(52.7±14.6)岁，男性占41.8%；患者自行出口处护理者占27.2%，出口处护理者不固定占15.0%，未经培训者占10.8%。多因素COX回归分析显示，出口处护理者不固定(HR=2.989，95% CI：1.089～8.206,  P =0.034)、出口处护理者未经过培训(HR=3.829，95% CI：1.630～8.994,P=0.002)、患者门诊随访间隔时间≤3个月(HR=0.389，95% CI：0.179～0.845,P=0.017)是老年腹膜透析患者导管出口处感染的独立影响因素。 结论 老年腹膜透析患者出口处感染发生率为0.15次/患者年。出口处护理者固定、护理者经规范培训、患者门诊随访间隔≤3个月可能会减少出口处感染的发生。
【关键词】腹膜透析； 出口处感染； 老年患者； 出口处护理者

关键词: 腹膜透析, 出口处感染, 老年患者, 出口处护理者

Abstract: This study was to explore the effect of caregiver on catheter exit-site infection in the incident elderly peritoneal dialysis (PD) patients.  Methods  The relevant data of the PD patients with catheterization at the age of ≥60 years in the PD Center of our hospital from January 2009 to December 2012 were recruited.  Results  A total of 213 incident elderly PD patients were recruited in this study. Their average age was 68.5±6.0 years old, with 51.6% males and 48.8% diabetes. The median follow-up period was 12.0 months. Twenty-eight patients (13.1%) had 30 episodes of exit-site infection with a rate of 80.9 patient-months (0.15 episodes/year/patient). Evaluation of the exit-site caregivers demonstrated that their mean age was 52.7±14.6 years, 41.8% were males, 27.2% patients took care of exit-site themselves, 15.0% patients had inconstant exit-site caregivers, and 10.8% had untrained exit-site caregivers. COX proportional risk regression showed that inconstant exit-site caregivers (HR=2.989, 95% CI: 1.089～8.206; P=0.034), untrained exit-site caregivers (HR=3.829, 95% CI: 1.630～8.994, P=0.002) and follow-up interval ≤3 months at the outpatient clinics (HR=0.389, 95% CI: 0.179～0.845, P=0.017) were the independent risk factors for catheter exit-site infections in the elderly PD patients.  Conclusions  The prevalence of exit-site infection in elderly PD patients was 0.15 episodes/year/patient. Stable caregivers, caregivers receiving standardized training by medical staff, and follow-up interval ≤3 months at the outpatient clinics may reduce the incidence of exit-site infection in incident elderly PD patients.

Key words: Peritoneal dialysis, Exit-site infection, Elderly patients, Catheter exit-site caregiver

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