出口处护理操作者对老年腹膜透析患者导管出口处感染的影响  

Effect of caregiver on catheter exit-site infection in elderly peritoneal dialysis patients

作　　者：鲁树超 吕珊 于晓丽[1,2] 阳晓[1,2] 林建雄[1,2] LU Shu-chao;LV Shan;YU Xiao-li;YANG Xiao;LIN Jian-xiong(Department of Nephrology,The First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080;Key Laboratory of Nephrology,Ministry of Health,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院肾内科,广州510080 [2]中山大学附属第一医院卫生部重点实验室,广州510080

出　　处：《中国血液净化》2022年第6期461-464,共4页Chinese Journal of Blood Purification

基　　金：国家自然科学基金(82074170,81774069);国家重点研发项目(2016YFC0906101);广东省重点实验室运行经费(2017B030314019);广东省科技计划(2017B020227006);广州市科技计划项目(201704020167)。

摘　　要：目的探讨出口处护理操作者对老年腹膜透析患者导管出口处感染的影响。方法收集2009年1月~2012年12月在中山大学附属第一医院肾内科腹膜透析中心置管的年龄≥60岁的腹膜透析患者的相关资料。结果213例老年腹膜透析患者纳入本研究。28例(13.1%)腹膜透析患者发生30例次出口处感染,出口处感染率为80.9患者月(0.15次/患者年)。出口处护理操作者评估结果显示:平均年龄(52.7±14.6)岁,男性占41.8%;患者自行出口处护理者占27.2%,出口处护理者不固定占15.0%,未经培训者占10.8%。多因素COX回归分析显示,出口处护理者不固定(HR=2.989,95%CI:1.089~8.206,P=0.034)、出口处护理者未经过培训(HR=3.829,95%CI:1.630~8.994,P=0.002)、患者门诊随访间隔时间≤3个月(HR=0.389,95%CI:0.179~0.845,P=0.017)是老年腹膜透析患者导管出口处感染的独立影响因素。结论老年腹膜透析患者出口处感染发生率为0.15次/患者年。出口处护理者固定、护理者经规范培训、患者门诊随访间隔≤3个月可能会减少出口处感染的发生。Objective This study was to explore the effect of caregiver on catheter exit-site infection in the incident elderly peritoneal dialysis(PD)patients.Methods The relevant data of the PD patients with catheterization at the age of≥60 years in the PD Center of our hospital from January 2009 to December 2012 were recruited.Results A total of 213 incident elderly PD patients were recruited in this study.Their average age was 68.5±6.0 years old,with 51.6%males and 48.8%diabetes.The median follow-up period was 12.0months.Twenty-eight patients(13.1%)had 30 episodes of exit-site infection with a rate of 80.9 patientmonths(0.15 episodes/year/patient).Evaluation of the exit-site caregivers demonstrated that their mean age was 52.7±14.6 years,41.8%were males,27.2%patients took care of exit-site themselves,15.0%patients had inconstant exit-site caregivers,and 10.8%had untrained exit-site caregivers.COX proportional risk regression showed that inconstant exit-site caregivers(HR=2.989,95%CI:1.089~8.206;P=0.034),untrained exit-site caregivers(HR=3.829,95%CI:1.630~8.994,P=0.002)and follow-up interval≤3 months at the outpatient clinics(HR=0.389,95%CI:0.179~0.845,P=0.017)were the independent risk factors for catheter exit-site infections in the elderly PD patients.Conclusions The prevalence of exit-site infection in elderly PD patients was 0.15 episodes/year/patient.Stable caregivers,caregivers receiving standardized training by medical staff,and follow-up interval≤3 months at the outpatient clinics may reduce the incidence of exit-site infection in incident elderly PD patients.

关 键 词：腹膜透析 出口处感染 老年患者 出口处护理者 

分 类 号：R473[医药卫生—护理学]