腹膜透析相关性腹膜炎影响因素分析及护理策略

Analysis of influencing factors and nursing strategy of peritonitis associated with peritoneal dialysis

目的:探讨腹膜透析相关性腹膜炎发生的影响因素,为制定相应的护理对策提供依据。方法:回顾性分析2012年1月至2019年12月期间在天津市某医院接受维持性腹膜透析治疗且规律随访的患者,分析患者的年龄、性别、文化程度、原发病、腹膜透析龄、胃肠道功能等资料,采用单因素和多因素Logistic回归分析影响腹膜透析患者发生腹膜透析相关性腹膜炎的因素。结果:研究期间接受维持性腹膜透析治疗的患者987例,发生腹膜透析相关性腹膜炎患者381例,8年间腹膜炎发生率呈下降趋势,年均0.19次/患者·年(1次/63.16患者月)。多因素Logistic回归分析结果显示,影响腹膜透析患者发生腹膜透析相关性腹膜炎的因素为年龄、文化程度、原发病为糖尿病、便秘、腹泻、血清白蛋白、腹膜透析龄、夏季等。结论:腹膜透析患者发生腹膜透析相关性腹膜炎与患者年龄、腹膜透析龄、文化程度、胃肠功能、糖尿病、血清蛋白、季节等密切相关。针对以上影响因素,早期预防性评估,加强宣教是降低腹膜透析相关性腹膜炎发生率的关键。

Objective:To explore the influencing factors of peritonitis associated with peritoneal dialysis,and to provide the basis for the nursing strategies.Methods:A retrospective analysis was performed on patients who received maintenance peritoneal dialysis and were regular follow-up at a hospital in Tianjin from January 2012 to December 2019.The data of all patients,such as age,sex,education level,primary disease,age of peritoneal dialysis,gastrointestinal function were collected and analyzed by univariate and multivariate Logistic regression methods.Results:A total of 987 patients received maitenance peritoneal dialysis,and 381 patients developed peritoneal dialysis associated peritonitis.The incidence of peritonitis showed a downward trend in the 8 years of the study,with an average annual rate of 0.19 times/patient·year(1 time/63.16 patient months).The results of multivariate Logistic regression analysis showed that the factors affecting the occurrence of peritoneal dialysis-related peritonitis were age,education level,the primary disease was diabetes,constipation,diarrhea,serum albumin,peritoneal dialysis age,summer,etc.Conclusion:According to the influencing factors,early preventive evaluation and strengthening of publicity and education were the key to reduce the incidence of peritonitis associated with peritoneal dialysis.