| 吕倩,赖晓全,徐敏,等.早发性腹膜透析相关性腹膜炎的病原菌特点及危险因素分析[J].安徽医药,2022,26(10):1940-1943. |
| 早发性腹膜透析相关性腹膜炎的病原菌特点及危险因素分析 |
| Pathogenic bacteria characteristics and risk factors for early-onset peritonitis in peritoneal dialysis patients |
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| DOI：10.3969/j.issn.1009-6469.2022.10.008 |
| 中文关键词: 腹膜炎 腹膜透析 前白蛋白 低白蛋白血症 伤口感染 危险因素 |
| 英文关键词: Peritonitis Peritoneal dialysis Prealbumin Hypoalbuminemia Wound infection Risk factors |
| 基金项目:国家自然科学基金项目( 71974062)；湖北省自然科学基金项目( 2019CFB112) |
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| 中文摘要: |
| 目的探讨早发性腹膜透析相关性腹膜炎影响因素及防控策略。方法选取华中科技大学同济医学院附属同济医院 2018年 1月至 2020年 12月行腹膜透析的 268例病人，采取回顾性研究对早发性腹膜透析相关性腹膜炎的危险因素进行分析，同时探讨腹膜透析相关性腹膜炎的相关防控策略。结果 268例腹膜透析的病人中有早发性腹膜炎的 52例，分离出病原菌共 47株，其中革兰阳性菌占比 55.32%(26/47)以表皮葡萄球菌为主，革兰阴性菌占比 29.79%(14/47)以大肠埃希菌为主，真菌占比 14.89%(7/47)，以光滑假丝酵母菌为主。，单因素分析显示文化程度小学及以下( χ2=21.82，P<0.00，1)、血钾低( χ2=5.25，P= |
| 英文摘要: |
| Objective To investigate the risk factors and preventive strategies for early-onset peritonitis in peritoneal dialysis pa. tients.Methods A total of 268 patients who underwent peritoneal dialysis in Tongji Hospital Affiliated to Tongji Medical College ofHuazhong University of Science and Technology from January 2018 to December 2020 were enrolled in the study. A retrospective studywas conducted to analyze the risk factors and preventive strategies for early-onset peritonitis in peritoneal dialysis patients.Results Among the 268 cases of peritoneal dialysis patients, 52 cases had early-onset peritonitis. Totally 47 strains of pathogens were isolated, 55.32% (26/47) of which were gram-positive bacteria,mainly Staphylococcus epidermidis, 29.79% (14/47) were gram-negative bacteria, mainly Escherichia coli, and 14.89% (7/47) were fungi, mainly Candida glabrata. Univariate analysis results showed that statisticallysignificant differences were found in primary school educational background and lower (χ2=21.82, P<0.001), lower serum potassium level (χ2=5.25, P=0.023), lower serum prealbumin level (χ2=82.61, P<0.001), lower albumin level (χ2=84.27, P<0.001) and catheter ex. it-site infection (χ2=40.46, P<0.001). Multivariate logistic regression analysis results showed that lower education level [OR=9.90, 95%CI:(3.66,26.83),P<0.001], lower serum prealbumin level [OR=9.76,95%CI:(3.06,31.11),P<0.001], lower serum albumin level [OR =3.34,95%CI:(1.15,9.68),P=0.027] and catheter exit-site infection [OR=12.83,95%CI:(3.13,52.60),P<0.001] were risk factors for ear. ly-onset peritonitis in peritoneal dialysis patients.Conclusions Lower education level, lower serum prealbumin, lower serum albumin level and catheter exit-site infection were independent risk factors for early-onset peritonitis in peritoneal dialysis patients. For patientswith lower education level, it is necessary to strengthen the training of the operation process, take measures to improve the nutritionalstatus of malnourished patients and disinfect the catheter exit-site regularly, which can prevent early-onset peritonitis in peritoneal dial. ysis patients . |
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