强化手卫生观念降低居家腹膜透析患者腹膜炎发生率

目的探讨强化手卫生观念在降低居家腹膜透析患者腹膜炎发生率中的作用。方法将90例居家腹膜透析患者随机分为观察组和对照组各45例。对照组出院时进行常规宣教,观察组成立居家腹膜透析健康教育小组进行健康教育,强化手卫生观念。干预后6个月比较腹膜炎发生率及洗手操作合格率。结果观察组腹膜炎发生率显著低于对照组,手卫生合格率显著高于对照组(均P 0. 01)。结论对居家腹膜透析患者强化手卫生观念可提高患者手卫生意识和依从性,从而降低居家腹膜炎发生率。     

国内外腹膜透析患者规范化培训现状比较

<正>腹膜透析(peritoneal dialysis,PD)是肾脏替代治疗的主要方式之一,许多国家和地区在推广腹膜透析优先的政策^[1]。世界范围内超过272 000患者在接受腹膜透析治疗,占全球总透析例数的11%,腹膜透析的年全球增长率估计为8%,其中,中国腹膜透析人数占全球总透析人数的20%^[1-3]。国内外接受PD的患者数越来越多,在发达国家PD已证实为进行肾脏替代治疗的一个优异方法,并被确认为透析治疗的一种标准形式^[4～6],腹膜透析患者人数已达到总透析人数35%～40%。1 PD的定义PD是利用人体自身的腹膜作为透析膜的一种透析方式。     

腹膜透析患者透析充分的评价

腹膜透析患者透析充分的评价朱莉，康子琦，李秀燕尿素动力学已成为评价血透充分的重要工具，但在腹透中的作用还有争论。我们对５９例ＣＡＰＤ患者进行尿素动力学研究，以探讨尿素动力学在评价腹透充分中的意义。病人与方法ＣＡＰＤ患者，男２６例，女３３例，平均透析年...     

腹膜透析患者透析充分性的临床研究

目的：评估腹膜透析患者充分透析的透析剂量。方法：以主观全面营养评价（ＳＧＡ）评分和血清白蛋白浓度为标准,对５８例腹膜透析患者作营养评价,并分析ＳＧＡ评分,血清白蛋白浓度与患者的透析剂量之间的关系。     

关注腹膜透析患者预后

腹膜透析（简称腹透）是终末期肾衰患者延续生命的有效治疗手段之一,多项大型研究显示腹膜透析具有与血液透析（简称血透）相同的临床效果,且具有很多优势,譬如：可以居家操作,免除了医院往返的劳顿;操作易学简便又安全;血液动力学影响小,能较好地保护残肾功能;同时腹透费用比血透低、患者数增加不受医院透析机资源限制、血行感染机会少,等等。因此,腹膜透析目前已经成为终末期肾衰竭替代治疗的重要方式。     

客观结构化临床考试用于腹膜透析患者培训的效果

目的 探讨客观结构化临床考试运用于腹膜透析患者培训的效果。 方法 将104例腹膜透析置管术患者随机分为对照组与观察组各52例。两组统一实施标准化培训,参加笔试和操作考核后对照组出院,观察组再参加客观结构化临床考试后出院。出院后随访6个月,比较两组笔试成绩、操作考核成绩、自我管理能力评分及腹膜炎发生情况。 结果 对照组47例、观察组50例完成研究。观察组出院后3个月及6个月自我管理能力量表评分、笔试成绩、腹透换液及出口护理考核评分显著高于对照组（均P＜0.05）,两组腹膜炎发生率及发生时间比较,差异无统计学意义（均P＞0.05）。 结论 在腹膜透析患者培训中运用客观结构化临床考试,能提高患者的自我管理能力及操作成绩,但对腹膜炎的影响尚有待进一步研究。     

糖尿病腹膜透析患者腹膜转运功能特点

在临床中我们常常发现,与其他持续性非卧床腹膜透析(CAPD)患者相比.糖尿病CAPD患者水肿症状更常见,我们探讨糖尿病CAPD患者相关的腹膜转运特点. 一、对象与方法 1.对象:选取本院腹秀中心CAPD患者67例,分为糖尿病组与非糖尿病组,透析时间为≥4周.     

糖尿病腹膜透析患者腹膜转运功能特点

在临床中我们常常发现,与其他持续性非卧床腹膜透析(CAPD)患者相比.糖尿病CAPD患者水肿症状更常见,我们探讨糖尿病CAPD患者相关的腹膜转运特点. 一、对象与方法 1.对象:选取本院腹秀中心CAPD患者67例,分为糖尿病组与非糖尿病组,透析时间为≥4周.     

糖尿病腹膜透析患者腹膜转运功能特点

在临床中我们常常发现,与其他持续性非卧床腹膜透析(CAPD)患者相比.糖尿病CAPD患者水肿症状更常见,我们探讨糖尿病CAPD患者相关的腹膜转运特点. 一、对象与方法 1.对象:选取本院腹秀中心CAPD患者67例,分为糖尿病组与非糖尿病组,透析时间为≥4周.     

腹膜透析患者如何达到长期充分性透析

透析充分性是影响腹透患者长期生存的最主要因素 ,而影响透析充分性的主要因素是透析剂量 ,腹膜转运功能 ,残余肾功能 ,体表面积 ,而这些指标又是不断变化的动态指标 ,因此我们透析方案必须不断修改。资料与方法1　病例选择　选取 1996年 1月～ 2 0 0 1年 10月在本院进行长期腹透并腹访的患者 5 0例。其中男 2 8例 ,女2 2例 ;年龄 2 7岁～ 84岁 ,平均 (5 2 .98± 15 .0 2 )岁。均采用百特双连系统透析。腹透治疗时间 3～ 71个月 ,平均透析(2 6 .14± 2 0 .0 1)月。原发病慢性肾小球肾炎 4 2例 ,原发性高血压 4例 ,慢性间质性肾炎 2例 ,痛风…     

Peritoneal dialysis in Mexico

While Mexico has the thirteenth largest economy, a large portion of the population is impoverished. About 90% of the population is Mestizo, the result of the admixture of Mexican Indians and Spaniards, with the Indigenous peoples concentrated in the southeastern region. Treatment for end-stage renal disease (estimated 268 patients per million population) is largely determined by the limited healthcare system and the individual's access to resources such as private insurance ( approximately 15%) and governmental sources ( approximately 85%). With only 5% of the gross national product spent on healthcare and most treatment providers being public health institutions that are often under severe economic restrictions, it is not surprising that many Mexican patients do not receive renal replacement therapy. Mexico uses proportionately more peritoneal dialysis than other countries; 1% of the patients are on automated peritoneal dialysis, 19% on hemodialysis and 80% on CAPD. Malnutrition and diabetes, important risk factors for poor outcome, are prevalent among the patients in CAPD programs.     

Peritoneal dialysis in infants

The need for maintenance dialysis for infants is rare, but peritoneal dialysis has been the modality of choice in cases of end-stage renal failure, for technical reasons. Problems include higher mortality rates and an inferior long-term outcome compared with that in older children. Also, no internationally accepted guidelines exist for dialysis in infants. Many children on maintenance peritoneal dialysis in Finland have congenital nephrotic syndrome of the Finnish type (NPHS1), and dialysis is started during infancy. In this commentary we discuss our practice of performing peritoneal dialysis in infants and experiences gathered from the literature.     

Peritoneal dialysis glossary 2009

A number of attempts to create a commonly accepted terminology regarding definitions and terms used for clinical entities, methods, problems, and materials encountered by health professionals involved in peritoneal dialysis (PD) were undertaken in the past, the last one in 1990. Later on, some relevant sporadic attempts in a number of textbooks have been made, but they did not include the whole spectrum of PD. This glossary is an attempt to address the need for a universally accepted PD terminology including the latest advances in PD connection systems and fluids.     

Peritoneal dialysis in Hungary

In 1991 the technical conditions and the number of patients receiving peritoneal dialysis were surveyed in the Hungarian nephrology and dialysing units. Not only the number of patients with chronic uraemia (undergoing dialysis + transplantation) is lower in this country as compared to the European average (106 and 236 per one million people, respectively), but also their distribution according to the type of treatment is different. For several years patients under intermittent peritoneal dialysis make up more than 10% of the cases and those under continuous ambulatory peritoneal dialysis less than 2% (in Europe: <2% and 4–43%, respectively). The survey also included the types of solution, disinfection and connecting devices used in peritoneal dialysis, as well as the incidence of peritonitis and the administration of antibiotics. The principles of biocompatibility, the function of interleukin, as well as the effectiveness and the conditions of continuous ambulatory peritoneal dialysis are summarized.     

Peritoneal dialysis catheter-related complications

The introduction of a double-cuff swan neck type catheter has reduced the frequency of peritonitis. The frequency of complications associated with insertion of this catheter has remained unknown. We evaluated these complications in patients aged < 20 years at the start of the chronic peritoneal dialysis using double-cuff swan neck catheters. SUBJECTS AND METHODS: The data from 221 double-cuff swan neck catheters of 126 patients inserted in our hospital between 1990 and 2001 were compared with 102 single-cuff straight catheters of 54 patients between 1982 and 1990. The frequency of catheter-related complications, such as dislocation, leakage with in/outflow malfunction and infection(exit-site/tunnel infection and peritonitis within a month after catheter insertion) were estimated. RESULTS: We observed 37 dislocations(17%), 37 leakages(17%) and 36 infections(16%) of all double-cuff swan neck catheters. Twenty-nine catheters were removed due to catheter-related complications: 18 dislocations(8%), 2 leakages(1%) and 9 infections(4%). Catheter removal due to dislocation occurred significantly more frequently in 12% of children who were > or = 6 years old than in 1% of children < 6 years old(p = 0.002). Eighty-three percent of dislocations could be returned by the whiplash method(alpha-replacer, JMS, Tokyo). Of all single-cuff straight catheters, 10 catheters were removed due to catheter-related complications: 4 dislocations(4%), 6 leakages(6%) and 12 infections(12%). CONCLUSION: A single-cuff straight type catheter was more frequently replaced because of leakage and infection than a double-cuff swan neck type catheter. A double-cuff swan neck catheter was more frequently replaced because of dislocation than a single-cuff straight catheter. When a double-cuff swan neck catheter is inserted particularly in older children, care should be taken to avoid dislocation.