透析相关腹膜炎患者感染的危险因素及预后分析

Analysis of risk factors and prognosis of patients with CAPD-related peritonitis

  • 摘要: 目的 对透析相关腹膜炎患者感染的危险因素及预后影响因素进行分析,为临床治疗提供依据。方法 选取2009年1月-2016年1月医院长期随诊197例接受持续不卧床腹膜透析(CAPD)患者为研究对象,记录患者治疗期间透析相关性腹膜炎的发生率及患者的预后情况,分析患者感染的危险因素及预后影响因素。结果 197例患者中,发生透析相关性腹膜炎患者42例(21.32%),其中单发性27例,多发性15例;年龄>75岁、高糖透析液使用、白蛋白(Alb)<30 g/L与腹膜炎的发生具有显著相关性,差异有统计学意义(P<0.05);155例未发生腹膜炎的患者预后良好,42例腹膜炎患者中37例预后良好,5例预后不良;年龄>75岁、多发性腹膜炎、Alb<25 g/L及血红蛋白(Hb)<80 g/L与腹膜炎患者的不良预后具有显著相关性(P<0.05)。结论 腹膜透析患者腹膜炎的发生与多种危险因素有关,积极纠正贫血、低蛋白血症,控制医源性的代谢及电解质紊乱对改善患者预后具有重要意义。

     

    Abstract: OBJECTIVE To analyze the risk factors and prognosis of patients with CAPD-related peritonitis, so as to provide evidence for clinical treatment. METHODS From Jan. 2009 to Jan. 2016, 197 patients with CAPD were chosen as study objects, and the occurrence of CAPD-related peritonitis and prognosis of patients were recorded. The risk factors and impact factors of prognosis were analyzed. RESULTS Totally 42 patients (21.32%) in 197 subjects were diagnosed with CAPD- related peritonitis, and 27 patients were single peritonitis and 15 patients were multiple peritonitis. Age>75 years old, use of high-glucose dialysate and Alb<30g were significantly related to peritonitis(P<0.05). The 155 patients without peritonitis and 37 patients with peritonitis had good prognosis, while the prognosis of 5 patients with peritonitis was poor. Age>75 years old, multiple peritonitis, Alb<25g/L and Hb<80g/L were significantly related to poor prognosis of patients with peritonitis(P<0.05). CONCLUSION CAPD-related peritonitis and poor prognosis are associated with multiple factors, and it is of great significance to improve the prognosis of patients by treatment of anemia and hypoproteinemia, and prevention of iatrogenic electrolyte/metabolic disorders.

     

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