长腹膜透析龄患者腹膜炎临床特征分析  

Analysis on the Clinical Characteristics of Peritonitis in Patients with Long Peritoneal Dialysis

作　　者：葛霄琳 曹艳佩[1] 袁立[1] 杨晓莉[1] GE Xiao-lin;CAO Yan-pei;YUAN Li(Huashan Hospital Affiliated to Shanghai Fudan University,Shanghai,200040,China)

机构地区：[1]上海市复旦大学附属华山医院

出　　处：《中国初级卫生保健》2019年第9期104-105,108,共3页Chinese Primary Health Care

摘　　要：目的探究长腹膜透析龄患者腹膜炎发生的临床特征。方法纳入2004—2016年间复旦大学附属华山医院发生腹膜炎患者,按初次感染发生在各一倍透析龄3年内及3年后分为两组,比较两组感染菌种及预后差异;同时分析不同透析龄及不同自然年致病菌的变化情况。结果本院2004—2008年间应用普通培养方式寻找致病菌,培养阴性率高达68%~95%,2009—2016年间改用血培养方式,培养阴性率降为18%~0%,血培养方式明显提高了培养阳性率。研究共纳入188人,初次发生感染在透析3年内135人,初次感染发生在透析3年后53人,初次感染发生在透析3年后患者更容易发生混合感染,并转血透及死亡风险更高。透析3年内感染共计204人次,透析3年后感染人次共计118人次,后者感染链球菌及表皮葡萄球菌风险更高,透析3年后感染者培养阴性率更低,死亡风险更高。结论长龄腹膜透析患者初次发生腹膜炎有更高的混合感染风险,其预后较差。OBJECTIVE To explore the clinical features of peritonitis in patients with long peritoneal dialysis. METHODS In the period from 2004 to 2016,patients with peritonitis in Huashan Hospital Affiliated to Fudan University were divided into two groups according to the initial infection occurred within 3 years of dialysis and 3 years later. The differences between these two groups were compared with the prognosis;the number of infections within 3 years and 3 After the year,the infected people were divided into two groups. The differenc es in the infections and prognosis between these two groups were compared. The changes of pathogenic bacteria in different dialysis ages and different natural years were also analyzed. RESULTS The center used common culture methods to find pathogenic bacteria from 2004 to 2008. The negative rate of culture was as high as 68%~95%. In 2009-2016,the blood culture method was changed,and the negative rate of culture was reduced to 18%~0%. Blood culture significantly increased the positive rate of culture. A total of 188 people were in cluded in the study. The first infection occurred in 135 people within 3 years of dialysis. The initial infection occurred in 53 people after 3 years of dialysis. The initial infection occurred after 3 years of dialysis. The patient was more prone to mixed infection,and hemodialysis and death were more risky. During the dialysis,the total number of infections was 204in 3 years,and the number of infections was 118 in 3 years after dialysis. The latter was infected with streptococcusand Staphylococcus epidermidis. Higher,after 3 years of dialysis,the negative rate of infectionwas lower,and the risk of death was higher. CONCLUSION The first time peritonitis in patients with peritoneal dialysis has a higher risk of mixed infection,and its prognosis is poor.

关 键 词：腹膜透析技术 腹膜炎 感染 预后 

分 类 号：R656[医药卫生—外科学]