广西腹膜透析开展情况及质量调查分析

A multicenter study on the application of peritoneal dialysis in Guangxi

目的调查终末期肾脏病患者腹膜透析质量及并发症情况,为改进腹膜透析质量提供依据。方法采用横断面调查方法,调查广西壮族自治区158家医院2014~2016年腹膜透析开展情况,统计开展腹膜透析医院数量,分析2014年、2015年和2016年行腹膜透析患者人数、腹透相关性腹膜炎、飘管、堵管情况及血压、血红蛋白、钙磷代谢、甲状旁腺激素(PTH)达标情况。结果调查的158家医院中仅有30家医院开展腹膜透析技术,而2014~2016年腹透患者≥25例的中心分别为11家、11家和12家。2014~2016年腹透转血透的比率分别为3.6%、4.8%和5.4%(P>0.05);死亡率分别为7.5%、4.5%和4.0%(P<0.05);腹膜透析相关性腹膜炎是腹膜透析的主要并发症;2014~2016年腹透患者血压控制达标率分别为42.5%、61.0%和72.1%(P<0.05),血红蛋白达标率分别为45.7%、46.7%和45.8%(P>0.05),钙磷代谢达标率分别为60.9%、73.8%和60.9%(P<0.05),PTH达标率分别为45.3%、49.5%和46.9%(P>0.05)。结论广西腹膜透析技术仅在小部分医院开展,普及范围较小,近3年来腹膜透析患者死亡率有所下降,血压、钙磷代谢等腹膜透析质量控制得到一定改善。

Objective To investigate the application of peritoneal dialysis for the patients with end-stage renal disease,and to provide the basis for improving the quality of peritoneal dialysis. Methods The cross-sectional study of peritoneal dialysis was performed on the patients with end-stage renal disease in 158 hospitals in Guangxi from 2014 to 2016. The number of the patients with peritoneal dialysis,peritoneal dialysis related peritonitis,floating pipe,pipe blockage,blood pressure,hemoglobin,calcium and phosphorus metabolism and parathyroid hormone（ PTH） of reaching standard were analyzed and compared among the three years. Results Peritoneal dialysis technology was carried out only in 30 hospitals in the survey. The number of the patients receiving peritoneal dialysis equal to or more than 25 cases was 11,11 and 12 in 2014,2015 and 2016 respectively. The rates of the patents transferred from peritoneal dialysis to hemodialysis in 2014,2015 and 2016 were 3. 6%,4. 8% and 5. 4%（ P 0. 05） respectively,and their mortality rates were 7. 5%,4. 5% and 4. 0%（ P 0. 05）. Peritonitis that related to peritoneal dialysis was the major complications during peritoneal dialysis. The rates of the patients whose blood pressure was well controlled were 42. 5%,61. 0% and 72. 1% in 2014,2015 and 2016 respectively（ P 0. 05）. The rates of hemoglobin reaching the standard were 45. 7%,46. 7% and 45. 8% in 2014,2015 and 2016 respectively（ P 0. 05）. the rates of calcium and phosphorus metabolism that were well-controlled were 60. 9%,73. 8% and 60. 9% in 2014,2015 and 2016 respectively（ P 0. 05）. The rates of PTH that were well-controlled were 45. 3%,49. 5% and46. 9% in 2014,2015 and 2016 respectively（ P 0. 05）. Conclusion Peritoneal dialysis technology is carried out in a small number of the hospitals in Guangxi. The mortality rate of the patients with peritoneal dialysis has declined over the past three years,and the quality of peritoneal dialysis such as the blood pressure,calcium and phosphorus metabolism has been improved to some extent.