腹膜透析患者拔管原因及危险因素分析  

Analysis of extubation causes and risk factors in peritoneal dialysis patients

作　　者：陈雁 王玲 刘兴红 侯世会 隗楷桢 万静芳 杨杰 CHEN Yan;WANG Ling;LIU Xinghong;HOU Shihui;KUI Kaizhen;WAN Jingfang;YANG Jie(Department of Nephrology,Army Characteristic Medical Center,Chongqing 400042,China)

机构地区：[1]陆军特色医学中心肾内科,重庆400042

出　　处：《现代医药卫生》2023年第20期3449-3453,共5页Journal of Modern Medicine & Health

摘　　要：目的分析腹膜透析(PD)患者拔管原因和危险因素,寻找提高PD患者技术生存率、降低退出率的对策。方法回顾性分析2007年1月1日至2020年12月31日该中心收治的接受PD患者682例,排除透龄小于3个月、资料不完整、死亡、肾移植、治愈患者。收集患者的一般资料,包括人口学资料(性别、年龄等)、临床资料(原发病、合并症、尿量等)和实验室资料(血肌酐、血尿素等)。将退出PD患者设为拔管组(224例),记录其退出时间和退出原因,其余患者设为在透组(458例),分析其拔管的原因及危险因素。结果PD相关性腹膜炎、患者要求转血液透析、胸腹瘘是患者拔管的重要原因。低清蛋白血症、低学历、男性是PD患者拔管的危险因素。结论预防和管理腹膜炎、改善患者营养和炎症状态、给予更多的社会支持、加强家庭管理、宣传教育、随访、透析后再培训均可降低PD患者拔管率,改善PD患者技术生存率及预后。Objective To analyze the causes and risk factors of extubation in peritoneal dialysis(PD)patients,and to find the countermeasures to improve the technical survival rate and reduce the exit rate.Methods A retrospective analysis was performed on 682 patients with PD admitted to this center from January 1,2007 to December 31,2020,excluding patients with dialysis age less than three months,incomplete data,death,kidney transplantation,and cure.General data of the patients were collected,including demographic data(gender,age,etc.),clinical data(primary disease,combined disease,urine volume,etc.)and laboratory data(blood creatinine,blood urea,etc.).The patients who withdrew from PD were set into the extubation group(224 cases),and their withdrawal time and reasons were recorded.The remaining patients were set into the dialysis group(458 cases),and the causes and risk factors of extubation were analyzed.Results Pd-related peritonitis,patients requiring hemodialysis,thoracoabdominal fistula were important reasons for extubation.Hypoalbuminemia,low education and male were the risk factors for extubation in PD patients.Conclusion Prevention and management of peritonitis,improvement of nutritional and inflammatory status of patients,more social support,strengthening family management,publicity and education,follow-up,and retraining after dialysis can reduce the extubation rate of PD patients and improve the technical survival rate and prognosis of PD patients.

关 键 词：腹膜透析 拔管 原因 危险因素 

分 类 号：R459.5[医药卫生—治疗学]