中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (06): 474-479.doi: 10.3969/j.issn.1671-4091.2024.06.017

• 护理研究 • 上一篇    

腹膜透析导管出口周围疖肿的发生情况及影响因素分析

门春翠    芦丽霞    乔 婕    楚新新    何玉婷    武 蓓    赵慧萍    王 梅   

  1. 100044 北京，1北京大学人民医院肾内科
  • 收稿日期:2023-12-29 修回日期:2024-04-09 出版日期:2024-06-12 发布日期:2024-06-12
  • 通讯作者: 赵慧萍 E-mail:huipingzhao2009@163.com
  • 基金资助:
    北京大学人民医院研究与发展基金(RDN 2016-01)；教育部留学回国启动基金(jwsl451)

Study on the occurrence and influencing factors of furuncle around the exit of peritoneal dialysis catheter

MEN Chun-cui, LU Li-xia, QIAO Jie, CHU Xin-xin, HE Yu-ting, WU Bei, ZHAO Hui-ping, WANGmei   

  1. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China
  • Received:2023-12-29 Revised:2024-04-09 Online:2024-06-12 Published:2024-06-12
  • Contact: 100044 北京，1北京大学人民医院肾内科 E-mail:huipingzhao2009@163.com

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摘要： 目的  探讨腹膜透析(peritoneal dialysis,PD)导管出口周围疖肿的发生情况及影响因素。 方法 选择2011年9月─2017年9月北京大学人民医院肾内科规律随访的PD患者，回顾其PD导管出口周围疖肿的发生情况及临床资料，分析其相关影响因素。 结果 183名PD患者入选研究，男性88例(占48.1%)，平均年龄(59.8±13.8)岁，透析龄27(15,51)月。其中23名(12.6%)患者发生36例次出口周围疖肿，发生率0.05次/风险年。14例次(占38.9%)患者疖肿发生部位以PD导管为中心、周围6～9点的位置。并发症方面：4例次(占11.1%)疖肿合并出口和/或隧道感染，无合并腹膜炎。Logistic回归分析结果显示：透析龄(OR=0.969，95% CI:0.941～0.998,P=0.039)、合并糖尿病(OR=3.014，95% CI:1.050～8.651，P =0.040)、血C反应蛋白(OR=1.154，95% CI:1.065～1.251，P＜0.001)是PD患者出口周围发生疖肿的独立危险因素。通过Logistic回归分析PD患者出口疖肿频发的相关因素，结果显示合并糖尿病(OR =5.513，95% CI:1.029～29.536，P =0.046)、C反应蛋白(OR=1.103，95% CI:1.016～1.197，P=0.019)是出口周围疖肿频发的独立危险因素。 结论  PD导管出口周围疖肿形成在PD患者中并不少见，可能发展为出口感染和/或隧道感染。对合并糖尿病、透析龄较短、C反应蛋白水平高的患者应重点关注出口周围疖肿的发生，并给予相应的预防宣教，从而预防出口和/或隧道感染。

关键词: 腹膜透析, 出口感染, 疖肿, 皮肤软组织感染

Abstract: Objective  To explore the occurrence and influencing factors of furuncle around exit of peritoneal dialysis (PD) catheters.  Methods  The PD patients who were followed up regularly from September 2011 to September 2017 in the Department of Nephrology, Peking University People’s Hospital were selected. The occurrence of furuncle and related clinical data were reviewed and analyzed.  Results  A total of 183 PD patients were enrolled in this study, 88 (48.1%) were male, the average age was 59.8±13.8 years, and the median PD duration was 27 (15, 51) months. Thirty-six episodes of furuncle around exit of PD catheter occurred in 23 (12.6%) patients (0.05 episodes/patient-year). The most common site of furuncle was at 6 to 9 o'clock position around PD catheters (14 episodes, 38.9%). In terms of complications, 4 episodes of furuncle (11.1%) were complicated with exit-site infection and/or tunnel infection, but without peritonitis. Logistic regression analysis showed that shorter PD duration (OR=0.969, 95% CI: 0.941～0.998, P=0.039), diabetes mellitus (OR=3.014, 95% CI: 1.050～8.651, P=0.040) and higher serum C-reactive protein (OR=1.154, 95% CI: 1.065～1.251, P<0.001) were the independent risk factors for occurrence of furuncle around exit of PD catheters. Binary logistic regression found that diabetes mellitus (OR=5.513, 95% CI: 1.029～29.536, P=0.046) and C-reactive protein (OR=1.103, 95% CI: 1.016～1.197, P=0.019) were the independent risk factors for frequent furuncle occurrence around exit of PD catheters.  Conclusions  Furuncle around exit of PD catheters is not uncommon in PD patients, and may develop into exit-site infection and/or tunnel infection. The patients with diabetes mellitus, shorter PD duration and higher level of C-reactive protein should be paid attention to the presence of furuncle around the exit, and should be given corresponding education to prevent exit-site infection and tunnel infection.

Key words: Peritoneal dialysis, Exit-site infection, Furuncle, Skin and soft tissue infection

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