分级管理在降低腹膜透析患者腹膜炎发生率中的应用

Application effect of hierarchical management on reducing the incidence of peritonitis among patients with peritoneal dialysis

目的：探讨降低持续不卧床腹膜透析（ CAPD ）患者腹膜炎发生率的方法。方法将2012年1—12月CAPD患者108例设为对照组，2013年1—12月CAPD患者150例设为试验组。试验组对传统管理的腹膜透析患者发生腹膜炎原因进行分析，在借鉴病房患者分级护理制度的基础上，制定实施腹膜透析患者分级管理方法，比较实施分级管理前后两组患者的腹膜炎发生率。结果分级管理后，腹膜透析患者腹膜炎发生率降低，由25．9次／患者月降至64．0次／患者月，两组比较差异具有统计学意义（χ2＝13．665，P＜0．01）。结论分级管理腹膜透析患者的方法可以降低腹膜透析中腹膜炎发生率，提高患者的自我管理能力及依从性。

Objective To explore the method to reduce the incidence of peritonitis patients with continuous ambulatory peritoneal dialysis （ CAPD ） .Methods We selected 108 patients with CAPD during January to December 2012 as control group and 150 patients received CAPD from January to December 2013 as experimental group.We analyzed reasons of peritonitis among patients with CAPD who received traditional management of CAPD, and draw on the experience of ward hierarchical management to set up and carry out CAPD patient′s hierarchical management.We compared the rates of peritonitis between two groups.Results After utilization of CAPD patient′s hierarchical management, the incidence of peritonitis reduced dramatically from 25.9 patient month once to 64.0 patient month once （χ2 =13.665;P〈0.01）.Conclusions The method of CAPD patient′s hierarchical management can effectively decrease the rate of peritonitis in peritoneal dialysis center and promote patient′s self-management and compliance.