腹膜透析相关性腹膜炎的影响因素分析  

Analysis of influencing factors of peritoneal dialysis associated peritonitis

作　　者：林慕仪 莫露璐 王纯[1] 赖晓纯[1] 温跃强[1] LIN Muyi;MO Lulu;WANG Chun;LAI Xiaochun;WEN Yueqiang(the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院,广东广州510260

出　　处：《临床医学研究与实践》2024年第28期1-4,共4页Clinical Research and Practice

摘　　要：目的 分析腹膜透析相关性腹膜炎(PDAP)的影响因素,以为临床腹膜透析(PD)患者的管理提供有利依据。方法 回顾性选取2021年1月至2022年12月规律随访的272例PD患者为研究对象,其中发生PDAP的患者作为观察组,未发生PDAP的患者作为对照组。分析PDAP患者的病原微生物培养结果;分析影响PD患者发生PDAP的因素。结果 272例PD患者中,118例发生PDAP,154例未发生PDAP。PDAP患者透出液细菌培养结果显示,阴性40例(33.90%);革兰氏阳性菌感染49例(41.53%),以唾液链球菌和金黄色葡萄球菌感染为主;革兰氏阴性菌感染23例(19.49%),以铜绿假单胞菌为主要病原微生物;结核菌感染4例(3.39%);混合细菌感染2例(1.69%)。多因素Logistic回归分析结果显示,血清白蛋白、血清总胆固醇和血钠是PDAP发生的保护因素(P<0.05)。结论 血清白蛋白、血清总胆固醇和血钠是PDAP发生的保护因素,PD中心管理人员应重视患者营养管理,保证适量和足量的优质蛋白及能量摄入,提高机体免疫力,从而避免腹膜炎的发生。Objective To analyze the influencing factors of peritoneal dialysis associated peritonitis(PDAP),and to provide a favorable basis for clinical management of peritoneal dialysis(PD)patients.Methods A total of 272 PD patients who were regularly followed up from January 2021 to December 2022 were retrospectively selected as the research objects.The patients with PDAP were selected as observation group,and the patients without PDAP were selected as control group.The results of pathogenic microorganism culture in PDAP patients were analyzed;the influencing factors of PDAP in PD patients were analyzed.Results A total of 118 cases had PDAP and 154 cases had no PDAP of the 272 PD patients.The results of bacterial culture of the dialysate of PDAP patients showed that 40 cases(33.90%)were negative;there were 49 cases(41.53%)of Gram-positive bacteria infection,mainly Streptococcus salivarius and Staphylococcus aureus infection;there were 23 cases(19.49%)of Gram-negative bacteria infection,with Pseudomonas aeruginosa as the main pathogenic microorganism;there were 4 cases(3.39%)of Tubercle bacilli infection;there were 2 cases(1.69%)of mixed bacterial infection.Multivariate Logistic regression analysis results showed that serum albumin,serum total cholesterol and serum sodium were protective factors for PDAP(P<0.05).Conclusion Serum albumin,serum total cholesterol and serum sodium are protective factors for PDAP.PD center managers should pay attention to the nutritional management of patients,ensure appropriate and sufficient high-quality protein and energy intake,and improve the immunity of the body,so as to avoid the occurrence of peritonitis.

关 键 词：腹膜透析 腹膜透析相关性腹膜炎 影响因素 

分 类 号：R692[医药卫生—泌尿科学]