腹膜透析相关性腹膜炎的原因分析  

Cause Analysis and Nursing of Peritoneal Dialysis-related Peritonitis

作　　者：周雪丽[1] 温月[1] 江维[1] 秦敏[1] 任英[1] 钟慧[1] 刁永书[1] 

机构地区：[1]四川大学华西医院肾内科,成都610041

出　　处：《华西医学》2013年第4期576-578,共3页West China Medical Journal

摘　　要：目的分析持续腹膜透析患者发生腹膜炎的情况及相关因素,降低腹膜透析患者腹膜炎发生率、退出率,提高患者的生存率、生活质量。方法回顾分析2011年1月-6月收治的41例在家中行持续非卧床性腹膜透析且发生腹膜炎患者的临床资料,观察腹膜炎的发生率及转归,腹膜炎症状出现后初始的处理,对腹膜炎的诱因进行分析。结果 41例腹膜透析患者共发生腹膜炎43例次,痊愈35例(85.4%),转血液透析3例(7.3%),死亡3例(7.3%)。在症状出现初期,3例(7.3%)患者继续在家观察,10例(24.4%)患者立即到当地就医,15例(36.6%)患者采用电话咨询,13例(31.7%)患者到腹膜透析中心就诊;18例(43.9%)患者直接将腹膜透析引流液带到医院进行药敏试验。就感染诱因而言,16例(39.0%)患者未严格进行空气消毒,13例(31.7%)患者未严格进行环境清洁,10例(24.4%)患者操作过程存在污染行为。结论加强对居家行腹膜透析患者的初次培训、操作指导及监测,可避免腹膜炎的发生,提高患者生活质量。Objective To analyze the occurrence of peritonitis in patients undergoing continuous peritoneal dialysis and its related factors, in order to reduce the incidence of peritonitis and exit rate, and improve the survival rate and quality of life of the patients. Methods We retrospectively analyzed the clinical data of 41 patients with peritoneal dialysis- related peritonitis in the Center of Peritoneal Dialysis in West China Hospital of Sichuan University from January 2011 to June 2011. Then, we observed the incidence, initial symptoms and outcome of peritonitis in these patients, and analyzed the causes of peritonitis. Results Forty-three cases of peritonitis occurred in the 41 patients. Thirty-five patients （85.4%） were cured; Three （7.3%） were transferred to hemodialysis; And another three patients （7.3%） died. On the initial symptoms, three patients （7.3%） stayed at home; ten （24.4%） went to the hospital immediately; 15 （36.6%） called doctors or nurses for help; and 13 （31.7%） went to the Center of Peritoneal Dialysis for treatment. Eighteen patients （43.9%） took fluid of drainage to the Center of Peritoneal Dialysis for examination. Sixteen patients （39.0%） didn＇t disinfect air strictly; 13 （31.7%） didn＇t clean the environment strictly; and 10 （24.4%） had polluted actions during the operating process. Conclusion Strengthening the initial training, formal implementation of practices, and following up and monitoring through telephone can avoid the occurrence of peritoneal dialysis-related peritonitis and improve patients＇ quality of life.

关 键 词：腹膜透析 感染诱因 腹膜炎 护理 

分 类 号：R459.5[医药卫生—治疗学]