腹膜透析患者早期腹膜炎发生情况的调查研究

目的探讨腹膜透析患者发生早期腹膜炎的危险因素。方法纳入某三级甲等医院2009年6月1日—2017年2月28日243例新入院的腹膜透析患者,随访至2018年3月31日。采用多因素Logistic回归分析早期腹膜炎的危险因素,分析早期腹膜炎的诱因、转归及病原学数据。结果纳入早期腹膜炎患者74例,多因素Logistic回归结果显示,导管出口感染与早期腹膜炎呈显著相关(OR=2.635,95%CI=1.289～5.388,P=0.008),革兰阳性菌是常见的致病菌,发生11例(68.75%)感染。导致早期腹膜炎发生常见的诱因为操作不当[6例(8.1%)]、腹泻或便秘[6例(8.1%)]及呼吸道感染[6例(8.1%)]。早期腹膜炎治愈65例(87.8%),复发或再发6例(8.1%)。结论腹膜透析导管出口感染是早期腹膜炎的独立危险因素,常见的病原体为革兰阳性菌,操作不当、腹泻或便秘及呼吸道感染是早期腹膜炎的常见诱因。

Investigation on risk factors and outcomes of early-onset peritonitis in peritoneal dialysis patients

Objective This study aims to investigate risk factors associated with early-onset peritonitis（EOP）. Methods 243 patients with peritoneal dialysis,admitted from 1 June 2009 to 28 February 2017,were enrolled and followed until March 31,2018. Logistic regression model was used to evaluate risk factors associated with EOP. Results There were 74 patients with EOP. A multivariate logistic regression analysis showed that catheter exit-site infection was significantly associated with EOP（OR=2.635,95%CI=1.289~5.388,P=0.008）. The most commonly causative pathogens of EOP were gram-positive organism with 11 Cases（68.75%）. The most common causes of EOP were contamination of improper operation with 6 cases（8.1%）,diarrhea or constipation with 6 casews（8.1%）,and respiratory infections with 6 casews（8.1%）. Conclusion Catheter exit-site infection was the independent risk factor associated with EOP in peritoneal dialysis patients. In addition,gram-positive organisms were the most commonly causative pathogens of EOP,and improper operation,diarrhea or constipation,and respiratory infections were the most common causes of EOP.