单个腹膜透析中心行腹膜透析致腹膜炎相关因素分析

Analysis of Related Factors of Peritonitis Caused by Peritoneal Dialysis in a Single Peritoneal Dialysis Center

目的:调查单个腹膜透析中心长期随访腹膜透析(PD)患者的数据库,分析和推断致腹膜炎的影响因素。方法:分析2008年1月~2016年12月9年间在单个腹膜透析中心进行连续不卧床PD治疗的367例患者,描述PD患者致腹膜炎的相关病原菌情况,并应用Logistic回归分析单中心腹膜透析患者致腹膜炎的影响因素。结果:本中心腹膜炎发病率为1∶45~1∶92个患者月,有161例次查出腹膜炎相关病原菌,主要是G+菌96株(47.1%),G-菌62株(30.4%),真菌3例(1.5%)。患者年龄大、透析龄长、白蛋白低、贫血和肠道功能紊乱是腹膜炎的危险因素。结论:单个腹膜透析中心PD患者致腹膜炎的危险因素有,患者年龄大、透析龄长、白蛋白低、贫血和肠道功能紊乱;因为有专职医生和护士门诊,实施滚动式健康教育等措施后,该中心的腹膜炎指标控制不错。但人力资源配备的不足存在很多隐患,建议PD护士专职化、专科化。

Objective：To analyze and infer factors affecting peritonitis by investigating a database of long-term peritoneal dialysis （PD） patients at a single peritoneal dialysis center. Methods ：January 2008 to December 2016 ,the 367 cases of PD patients treated with continu- ous ambulatory peritoneal dialysis in a single center were followed and investigated through 9 years to describe the related pathogens condi- tions and analyze the influencing factors that cause peritonitis by logistic regression analysis. Resuhs：The incidence of peritonitis in our hospital ranged from 1：45 to 1：92 per month. There were 161 times investigating peritonitis related pathogens, including 96 strains of G ~ bacteria（47.1% ） ,62 strains of G- bacteria（30.4% ） ,and 3 cases of fungi（ 1.5% ）. Patients with elder age,long dialysis duration,low albumin, anemia, and intestinal dysfunction are risk factors for peritonitis. Conclusion：There are some risk factors to cause a single perito- neal dialysis center PD patients with peritonitis, including eider age, dialysis duration, low albumin, anemia and intestinal disorders. Be- cause there are full-time doctors and nurses outpatient service, after the implementation of rolling health education and other measures, the center of peritonitis control indicators are well. However, because of the lack of human resources, there are many hidden dangers, and it is recommended that PD nurses should develop into full-time and more specialized direction.