腹膜透析相关隧道及外出口感染的原因分析

Analysis of infection origination during peritoneal dialysis

目的:研究腹膜透析相关隧道及外出口感染的原因,以指导制订护理措施,预防隧道及外出口感染,预防腹膜炎发生,提高透析质量。方法:回顾性分析2011年3月-2016年6月,共15例腹膜患者中发生隧道及外出口感染患者的临床资料,通过观察分析因素:性别、原发病情况(糖尿病、高血压)、透析时间、感染细菌种类、感染的时间、其他造成感染的原因如牵拉导管、游泳、cuff外露等,得出引起隧道及外口感染的危险因素。结果:14例腹膜透析患者中,发生透析相关隧道及外出口感染患者为14例15例次,其中隧道感染2例次,外出口感染13例次,细菌检出阳性率为80%,透析时间≤12透析月的患者占多数(占66.67%),1例感染金葡菌的隧道炎患者治疗效果不明显拔出腹透管转血透,感染治愈14例次,2例患者并发腹膜炎,1例患者外cuff外露,共发生2次外出口感染,葡萄球菌的感染率最高(占40%),原发病为高血压的患者占53.33%,糖尿病患者次之(26.67%),操作时不戴口罩占20%,牵拉导管造成损伤占20%,cuff外露占13.33%,夏秋季节感染率高分别占40%、26.67%。结论:医护人员应该关注腹膜透析患者的医从性及对正确换药的重视度,特别对新腹透患者及已发生过感染的患者,进行培训、考试及规律随访。

Objective:To study the causes of peritoneal dialysis related exogenous infections.Methods:15patients with congenitaland exogenous infection were analyzed retrospectively by observational factors:gender,primary condition(diabetes mellitus,hypertension),dialysis time,the type of infection of bacteria,the time of infection,and other causes of infection,such as traction catheter,swimming,cuffexposed.Results:14cases were followed up,there were2cases of tunnel infection,13cases of external export infection,80%of bacterialdetection rate,80%of dialysis time≦12dialysis months accounted for the majority of patients(66.67%),1case of Staphylococcus aureusinfection in patients with tuberculosis treatment;14cases of infection cure,2patients with peritonitis,(26%),the patients with primarydisease were53.33%of hypertension,followed by diabetes(26.67%),the operation was not the same as that of patients with diabetesmellitus Wearing a mask accounted for20%,traction catheter damage accounted for20%,cuff exposed accounted for13.33%,summerinfection rate was40%,26.67%.Conclusion:Health care workers should pay attention to the medical treatment of patients with peritonealdialysis and the importance of correct dressing,especially for patients with new abdomen and patients who have been infected,training,examination and regular follow-up.