儿童腹膜透析相关性腹膜炎的病原学及危险因素分析  

Analysis of etiology and risk factors of peritoneal dialysis-related peritonitis in children

作　　者：杨建环[1] 王德选[1] 陈敏广[1] 邢超[1] YANG Jian-huan;WANG De-xuan;CHEN Min-guang;XING Chao(Department of Pediatric Nephrology,the Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院,育英儿童医院儿童肾内科,浙江温州325027

出　　处：《中国卫生检验杂志》2021年第10期1237-1239,共3页Chinese Journal of Health Laboratory Technology

基　　金：温州市科技计划项目(Y20180011)。

摘　　要：目的腹膜透析相关性腹膜炎(peritoneal dialysisrelated peritonitis,PDRP)是儿童腹膜透析中常见的并发症,本文将探讨终末期肾脏病患儿PDRP发生的危险因素及相关病原学。方法回顾性分析2015年-2019年在本院儿童肾脏科接受腹膜透析患儿共37例,收集患儿住院期间病原学等临床资料。结果37例腹膜透析患者中有18例患儿共发生27次腹膜炎,PDRP的发生率为0.66次/年。其中51.85%由革兰阳性菌引起,18.52%由革兰阴性菌引起;表皮葡萄球菌是革兰阳性菌中最常见的病原菌,大肠埃希菌是革兰阴性菌中最常见的病原菌。在多因素分析中,低蛋白血症是腹膜透析相关性腹膜炎的危险因素(OR=23.173,95%CI:2.342~229.226,P=0.007)。结论革兰阳性菌仍是腹膜透析相关性腹膜炎的主要致病菌;腹膜炎的治疗应根据细菌培养及药敏试验选择敏感有效的抗生素。腹膜炎的发生与患儿的低蛋白血症相关。Objective Peritoneal dialysis related peritonitis(PDRP)is a common complication of peritoneal dialysis in children.This paper will discuss the risk factors and etiology of PDRP in children with end-stage renal disease.Methods A total of 37 children with peritoneal dialysis from 2015 to 2019 were analyzed retrospectively.Results Of the 37 peritoneal dialysis(PD)patients,27 times of peritonitis occurred in 18 children,and the incidence of PDRP was 0.66 times per year.Among them,51.85%were caused by Gram-positive bacteria and 18.52%by Gram-negative bacteria.Staphylococcus epidermidis is the most common pathogen of Gram-positive bacteria,and Escherichia coli is the most common pathogen of Gram-negative bacteria.In multivariate analysis,hypoproteinemia was a risk factor for PD associated peritonitis(OR=23.173,95%CI:2.342-229.226,P=0.007).Conclusion Gram-positive bacteria are still the main pathogens of PDRP,and the effective antibiotics should be selected according to bacterial culture and drug sensitivity test.Peritonitis is associated with hypoproteinemia in children.

关 键 词：腹膜炎 腹膜透析 儿童 

分 类 号：R446.1[医药卫生—诊断学]