血清白蛋白对腹膜透析患者并发腹膜炎的临床研究

Clinical Study on Serum Albumin in Patients with Peritoneal Dialysis Complicating Peritonitis

目的探讨血清白蛋白与腹膜透析患者并发腹膜炎的相关性。方法选取我院2008年3月至2015年4月收治的76例腹膜透析并发腹膜炎患者为研究对象,根据患者的血清蛋白水平将其分为观察组(血清蛋白含量≤35 g/L)和对照组(血清蛋白含量>35 g/L),各38例。观察腹膜透析液培养结果,并分析腹膜透析并发腹膜炎的原因及预后情况。结果观察组的培养阴性率为60.53%,明显高于对照组的34.21%(P<0.05);两组患者培养阳性中G^+球菌、G-杆菌比例差异不显著(P>0.05)。观察组腹膜透析并发腹膜炎原因中操作污染、原因不清楚的比例均高于对照组(P<0.05),两组患者在导管相关感染、胃肠道疾病、菌血症等方面比较无明显差异(P>0.05)。观察组患者死亡率为10.53%,明显高于对照组的0.00%(P<0.05);两组患者退出拔管(转血透)情况无明显差异(P>0.05)。结论与血清白蛋白含量正常的腹膜透析患者相比,血清白蛋白含量低的患者具有更高的腹膜透析液培养阴性率和患者死亡率。

Objective To investigate the correlation of serum albumin and patients with peritoneal dialysis complicating peritonitis. Methods From March 2008 to April 2015, 76 cases of patients with peritoneal dialysis complicating peritonitis admitted to our hospital were selected as research subjects. According to the level of serum protein, all patients were divided into observation group （serum protein ≤35 g/L） and control group （serum protein〉35 g/L）, with 38 cases in each group. The cultures of peritoneal dialysis fluid were observed, the results and prognosis of peritoneal dialysis complicating peritonitis were analyzed. Results The culture negative rate in observation group was 60.53%, significantly higher than 34.21% in control group （P 〈0.05）; the rate of G＋ coccus and G- bacillus of positive culture in two groups had no statistical difference （P 〉0.05）. The rate of operational pollution, unclear results of the causes of peritoneal dialysis complicating peritonitis in observation group were significantly higher than those in control group （P〈0.05）, but the rate of catheter related infections, gastrointestinal diseases and bacteremia in two groups had no statistical difference （P〉0.05）. The mortality in observation group was 10.53 %, significantly higher than 0.00% of control group （P 〈0.05）, the conditions of catheter removal in two groups had no statistical difference （P 〉0.05）. Conclusions Compared with peritoneal dialysis patients with normal serum protein level, patients with low serum albumin level have higher culture negative rate of peritoneal dialysis fluid and mortality.