单中心腹膜透析相关性腹膜炎特点  

Characteristics of single-center peritoneal dialysis-associated peritonitis

作　　者：齐雪婷 李国娜 薛嵘[1] 张军芳 贾京京 黄文辉[1] 李莹屏[1] Qi Xueting;Li Guona;Xue Rong;Zhang Junfang;Jia Jingjing;Huang Wenhui;Li Yingping(Nephrology Department of Gansu Provincial Hospital,Lanzhou 730000,China;Perinatal Medical Center of Gansu Provincial Maternity and Child care Hospital,Lanzhou 730050,China;Hemodialysis room of Jingning County Hospital,Pingliang 743400,China;Hemodialysis room of Kangxian First People's Hospital,Longnan 746599,China)

机构地区：[1]甘肃省人民医院肾内科,甘肃兰州730000 [2]甘肃省妇幼保健院围产医学中心,甘肃兰州730050 [3]静宁县医院血液透析室,甘肃平凉743400 [4]康县第一人民医院血液透析室,甘肃陇南746599

出　　处：《临床荟萃》2025年第4期334-338,共5页Clinical Focus

基　　金：兰州市科技发展计划项目艾考糊精腹透液对于腹膜透析患者的获益(2023-ZD-16)。

摘　　要：目的探讨单中心腹膜透析相关性腹膜炎(peritoneal dialysis associated peritonitis,PDAP)患者的病原菌类型、感染原因、预后情况。方法选取2015年1月-2024年1月于甘肃省人民医院腹膜透析(peritoneal dialysis,PD)门诊长期规律随访的PD患者412例。根据患者是否发生PDAP分为PDAP组(n=91)和对照组(n=321),比较两组一般情况和实验数据,分析发生PDAP的病原菌类型、感染原因、预后情况。结果与对照组比较,PDAP组年龄、PD龄均较大,前白蛋白水平、血浆白蛋白水平、血红蛋白水平均较低,差异均有统计学意义(P<0.05)。PDAP组共发生腹膜炎121例次。PDAP组细菌培养阳性率84.30%;革兰阳性菌占83.33%,是PDAP的主要致病菌,其中以表皮葡萄球菌为主,占41.18%。PDAP组感染原因中原因不明占39.67%,与操作相关占24.79%,不洁饮食占22.31%。腹膜炎治愈率89.26%,拔管转血液透析占10.74%。结论甘肃省人民医院PD中心PDAP除外原因不明大部分与PD操作相关,其次是进食过夜食物。需加强患者操作的规范性和饮食的健康教育。Objective To investigate the types of pathogens,causes of infection and prognosis of peritoneal dialysis associated peritonitis(PDAP)in a single center.Methods A total of 412 PD patients with long-term regular follow-up in the Peritoneal Dialysis Clinic of Gansu Provincial Hospital from January 2015 to January 2024 were selected.According to the occurrence of PDAP,the patients were divided into the PDAP group(n=91)and control group(n=321).The general conditions and experimental data of the two groups were compared,and the types of pathogenic bacteria,causes of infection and prognosis of PDAP were analyzed.Results Compared with the control group,patients in the PDAP group had significantly older age and onset of PD,and lower prealbumin,plasma albumin and hemoglobin(P<0.05).A total of 121 cases of peritonitis occurred in 91 patients in the PDAP group.The positive rate of bacterial culture in PDAP group was 84.30%.Gram-positive bacteria accounted for 83.33%,which was the main pathogenic bacteria of PDAP,among which Staphylococcus epidermidis was the main pathogen,accounting for 41.18%.In the PDAP group,39.67%of the causes of infection were unknown,24.79%were related to operation,and 22.31%were unclean diet.The cure rate of peritonitis was 89.26%,and the rate of extubation to hemodialysis was 10.74%.Conclusion Except for unknown reasons,PDAP in the peritoneal dialysis center of Gansu Provincial People's Hospital was mostly related to PD operation,followed by eating overnight food.It is necessary to strengthen the standardization of patient operation and health education of diet.

关 键 词：腹膜炎 腹膜透析 病原菌 

分 类 号：R572.2[医药卫生—消化系统]