更换短管对腹透相关性腹膜炎预后的影响

目的探讨更换短管与否对腹透相关性腹膜炎预后的影响。方法采取前瞻性随机对照的研究方法,将我院2008年1月至2011年1月收治的83例腹透相关性腹膜炎患者随机分为观察组(更换短管组38例)与对照组(不更换短管组45例),两组患者在发生腹膜炎时均由同一腹透护士行腹腔冲洗至腹透液清亮后,观察组予更换腹膜透析短管,对照组不予更换短管,再均按国际腹膜透析学会腹膜炎治疗指南规范使用抗生素,比较两组患者腹膜炎症状改善时间、半年内腹膜炎复发率有无差异。结果观察组38例中3例拔除腹膜透析管,拔管率为7.89%,半年内11例复发(28.94%),腹透液清亮时间为(5.18±4.41)d,腹痛消失时间为(3.03±2.94)d;对照组45例中5例拔除腹膜透析管,拔管率为11.11%、半年内12例复发(26.66%),腹透液清亮时间为(5.09±3.59)d,腹痛消失时间为(2.73±2.93)d;拔管率、腹膜炎复发率、腹透液清亮时间、腹痛消失时间两组比较差异均无统计学意义(均P>0.05)。结论发生腹透相关性腹膜炎时更换短管与否对腹透相关性腹膜炎预后无明显影响。不予更换短管可减少护士的工作量,并降低患者的医疗费用。

Effect of exchanging PD transfer set on the prognosis of peritoneal dialysis associated peritonitis

Objective To evaluate the effect of exchanging PD transfer set on the prognosis of peritoneal dialysis associated peritonitis. Methods A perspective randomized controlled clinical trial was conducted. Eighty-three patients with peritoneal dialysis associated peritonitis from Jan.2008 to Jan.2011 were divided into two groups. Observation group（38 patients）was exchanged PD transfer set when peritonitis happened, while controlled group（45 patients）was not exchanged. The improved period of the symptoms in peritonitis and the recurrence rate within half a year were compared between the two groups. Results In the observation group, peritoneal dialysis catheters were removed in three patients（7.89%）, peritonitis recurred in eleven patients in half a year（28.94%）, the period was 5.18±4.41 days when peritoneal dialysis fluid cleared,and 3.03±2.94 days when abdominal pain disappeared. In the controlled group, peritoneal dialysis catheters were removed in five patients（11.11%）, peritonitis recurred in twelve patients（26.66%）,the period was 5.09±3.59 days when peritoneal dialysis fluid cleared,and 2.73±2.93 days when abdominal pain disappeared. There were no significant differences between the two groups（P〉0.05）. Conclusion There is no significant effect of exchanging PD transfer set when peritoneal dialysis associated peritonitis happens. Without exchanging PD transfer set can reduce work capacity of nurses and decrease medical costs of patients.