腹膜透析患者再次发生腹膜炎的相关因素分析

Analysis on the related factors of reoccurence of peritonitis in pateints with peritoneal dialysis

目的探讨持续非卧床腹膜透析患者再次发生腹膜炎的相关因素，为预防再次腹膜炎发生提供临床依据。方法回顾性分析12例共32例次腹透相关性腹膜炎患者及操作者的文化程度、患者原发疾病、年龄、Hb、Alb、腹膜炎发生的可能原因、透析时间、医疗付费方式等因素，比较上述因素与腹膜炎发生的相关性。结果腹透相关性腹膜炎再次腹膜炎发生与患者年龄、操作者的文化程度、Hb、Alb、透析时间、操作者、原发疾病有关（P〈0．05），老年人、患者及操作者文化程度较低、营养状况差、原发病为糖尿病、透析时间在1-3年患者易再次发生腹膜炎，而与性别及医疗付费方式无关（P〉0．05），操作不规范、便秘、腹泻是腹膜炎再次发生的主要原因。结论对老年腹透患者、Alb和Hb较低、糖尿病、患者及操作者文化程度低、透析时间在1～3年的患者，特别是家属操作者要加强随访管理、再培训，防止腹膜炎再次发生。

Objective To explore the related factors of reoccurence of peritonitis in pateints with continous ambulatory peritoneal dialysis in order to provide clinical basis for preventing the reoccurence of peritonitis. Methods The education degree, primary diseases, ages, Hb, Alb, the possible reason of peritonitis, dialysis time and payment method of medical expenses of 12 cases with peritoneal dialysis-ralted peritonitis for 32 times and operators were retrospectively analyzed. The correlation between the above factors and the occurence of peritonitis was compared. Results The reoccurrence of peritonitis among pateitns with the peritoneal dialysis-related peritonitis was related with the ages, the education degrees of operators, Hb, Alb, the dialysis time and the primary diseases （ P 〈 0. 05 ）. Those pateints with advanced ages, lower education degrees of patients and operators, poor nutrition situations, primary disease of diabetes mellitus, and dialysis times of 1 to 3 years were prone to suffer peritonitis again. But there was no relation with the gender and the payment method of medical expenses （ P 〉 0. 05 ）. The main reasons for reoccurence of peritonitis were non-standard operation, constipation and＇ diarrhea. Conclusions The pateints with advanced ages, lower Alb and Hb, lower education degrees of patients and operators, diabetes mellitus, and dialysis times of 1 to 3 years, especially the family member operators, should be strenghtened the follow-up management and re-training, thereby preventing the reoccurence of peritonitis.