中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (07): 350-352.doi: 10.3969/j.issn.1671-4091.2016.07.008

• 临床研究 • 上一篇    下一篇

两种经验治疗方案治疗腹膜透析相关腹膜炎的疗效比较

邓行江,黄洁平,何建发,何敏,张魁正   

  1. 汕头大学医学院附属粤北人民医院肾内科
  • 收稿日期:2016-01-14 修回日期:2016-05-04 出版日期:2016-07-12 发布日期:2016-07-12

Comparison of two empirical therapies for the treatment of peritoneal dialysis related peritonitis

  • Received:2016-01-14 Revised:2016-05-04 Online:2016-07-12 Published:2016-07-12

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摘要： 目的探讨两种经验治疗方案治疗腹膜透析相关腹膜炎的疗效。方法对134 例腹膜透析相关性腹膜炎患者进行细菌培养及耐药性试验，给予59 例患者头孢唑啉联合头孢他啶治疗(CC 组)，给予75 例万古霉素联合头孢他啶治疗(VC 组)，比较两组有效率。结果头孢唑啉的耐药率为39.42%，头孢他啶耐药率为45.08%，无耐万古霉素菌株出现；CC 组革兰氏阳性菌感染率为57.63%与VC 组的52.00%无显著性差异(χ2=0.924，P=1.026)；CC 组初始治疗及2 周后有效率(79.66%，91.53%)与VC 组(82.67%，93.33%)比较差异无统计学意义(初始治疗χ2=1.041，P=0.873；2 周后有效率χ2=0.985，P=0.926)。结论两种经验治疗方案治疗腹膜透析相关腹膜炎均有显著疗效，可用于临床推广。

关键词: 腹膜透析, 头孢唑啉, 腹膜炎, 头孢他啶, 万古霉素, 药敏

Abstract: Objective To investigate the effect of two empirical therapies for the treatment of peritoneal dialysis (PD)- related peritonitis. Methods Bacterial culture and drug resistance tests were performed for 134 patients with PD- related peritonitis. Fifty- nine patients were treated with cefazolin plus ceftazidime (group CC), and 75 patients were treated with vancomycin plus ceftazidime (group VC). Therapeutic efficacy was compared between the two groups. Results the rate of drug resistance was 39.42% to cefazolin, and was 45.08% to ceftazidime. No strains resistant to vancomycin were found. The infection rate of Gram-positive
bacteria was 57.63% in group CC and was 52% in group VC (χ2=0.924, P=1.026). Effective rates at the early period of the treatment and after 2 weeks were 79.66% and 91.53% respectively in group CC, and were 82.67% and 93.33% respectively in group VC, without significant difference in efficacy between the two
groups (χ2=1.041, P=0.873 for early period of treatment; χ2=0.985, P=0.926 after the treatment for two weeks). Conclusion Both the two kinds of therapies were effective for the treatment of PD-related peritonitis, and can be recommended for clinical use.

Key words: Peritoneal dialysis, Cefazolin, Peritonitis, Ceftazidime, Vancomycin , Drug sensitivity