中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (08): 415-418.doi: 10.3969/j.issn.1671-4091.2013.08.00

• 临床研究 • 上一篇    下一篇

抗生素用药在预防腹膜透析置管术后腹膜炎的重要性研究

郑佳麒1,熊祖应1,熊子波1,梁伟1,廖玉梅2,徐春华2,高敏3,熊萍1   

  1. 1. 北京大学深圳医院
    2. 深圳市福田区莲花路北大深圳医院肾内科
    3. 北京大学深圳医院肾内科
  • 收稿日期:2013-02-06 修回日期:2013-05-10 出版日期:2013-08-12 发布日期:2013-08-12
  • 通讯作者: 熊子波 xiong0301@163.com E-mail:xiong0301@163.com

The importance of antibiotic prophylaxis for newly placed peritoneal dialysis catheter in preventing postoperative peritonitis

  • Received:2013-02-06 Revised:2013-05-10 Online:2013-08-12 Published:2013-08-12

RichHTML

1

PDF

166

摘要： 目的 比较不同预防性用药方案在新置腹膜透析导管患者的使用情况，探讨抗生素用药在预防新置腹膜透析导管患者术后发生腹膜炎的重要性。方法 回顾性分析2008年10月至2012年10月在北京大学深圳医院肾内科腹透中心接受腹膜透析置管术开始行腹膜透析治疗的患者173例。按照预防性使用抗生素方法分为三组，A组：患者在腹膜透析置管术后3天内使用含有头孢唑啉0.25g/L的腹透液，共计101例次；B组：患者在腹膜透析置管术前3小时静脉滴注头孢唑林0.5g，共计48例次；C组：患者术前及术后3天均未使用抗生素，共计24例次。比较三组病人术后14天内腹膜炎的发生率。结果 A组101例患者中1例出现腹膜炎，发生在术后第11天，占0.99%；B组48例患者中2例出现腹膜炎，均发生在术后第1天，占4.17%；C组24例患者中4例出现腹膜炎，3例发生在术后第1天，1例发生在术后第2天，占16.67%。对三组患者腹膜炎发生率进行两两比较，A组与C组比较，P＜0.01，差异有统计学意义；B组与C组比较，P＞0.05，差异无统计学意义；A组与B组比较，P＞0.05，差异无统计学意义。结论 腹膜透析置管术围手术期预防性抗生素用药十分有必要，术后腹腔内给药或术前一次静脉用药能有效预防术后腹膜炎发生。

关键词: 腹膜透析, 腹膜炎, 头孢唑林, 抗生素预防

Abstract: Objective To evaluate the efficiency of two antibiotic prophylactic regimens in our peritoneal dialysis center. Methods Retrospective analysis of 173 patients undergoing insertion of catheters from October 2008 to October 2012. The prophylactic regimens were a single dose of cefazolin (0.5g) given intravenously 3 hours before surgery (Group A) and given cefazolin (0.25g/L) in each dialysis bag within 3 days postoperatively (Group B). Patients in group C were not administered antibiotics preoperatively for at least 3 days before surgery, they were not administered antibiotics postoperatively for at least 3 days after surgery either. Patients were monitored for peritonitis in the following 14 days after surgery. Results One of 101 patients (0.99%) in the group A , and two of 48 patients (4.17%) in the group B, and four of 24 patients (16.67%) in the group C showed peritonitis during the post-operative period (within 14 days). Peritonitis developed in group A compared with group B, P＞0.05. Peritonitis developed in group A compared with group C, P＜0.01. Peritonitis developed in group B compared with group C, P＞0.05. Conclusion There is significant difference in the incident of peritonitis between group A and group C. Absence of prophylaxis is associated with a high risk for developing postoperative peritonitis. Given cefazolin in each dialysis bag within 3 days postoperatively can reduces the risk for postoperative peritonitis. And it did better than A single dose of cefazolin given intravenously before surgery.

Key words: Peritoneal dialysis, Peritonitis, Cefazolin, Antibiotic prophylactic