培养阴性腹膜透析相关性腹膜炎的预后探讨

目的：探讨培养阴性腹膜透析相关性腹膜炎的预后。方法：回顾性分析对比了我院2007年1月～2010年6月培养阴性及阳性腹膜透析相关性腹膜炎的近期抗生素使用情况及预后。结果：2007年1月～2010年6月收治的腹膜透析相关性腹膜炎124例共234例次,培养阳性者117例次（75.6%）,培养阴性57例次（24.4%）。与培养阳性者相比,培养阴性者具有更高的近期抗生素使用史（28%vs10%,P〈0.01）及更高的死亡率（10.5%vs1.7%,P〈0.01）;而治愈率（75.4%vs85.9%）、拔管率（7.0%vs7.9%）及复发率（7.0%vs4.5%）方面,培养阴性者差异无统计学意义（P〉0.05）。结论：培养阴性腹膜透析相关性腹膜炎可能预示着不良预后,近期抗生素使用史是其产生的原因之一。

Prognosis of Culture-negative Peritonitis In Peritoneal Dialysis Patients

Objective：To investigate the prognosis of culture-negative peritonitis in peritoneal dialysis patients.Methods：The contrast of culture-negative and culture-positive peritonitis in the history of previous antibiotic treatment and prognosis were made according to the data form January 2007 to July 2010 at our medical center.Results：There were 234 episodes of peritonitis occurred in 124 individuals between January 2007 and July 2010.The positive rate of culture was 75.6%,and the negative rate was 24.4%.A history of previous antibiotic treatment for peritonitis was more common with culture-negative than culture-positive peritonitis （28% vs 10%;P0.01）.Compared with culture-positive peritonitis,culture-negative peritonitis had much higher death rate（10.5% vs 1.7%,P0.01）.And the rates of cure（75.4% vs 85.9%,P0.05）,catheter removal（7.0% vs 7.9%,P0.05） and Relapse （7.0% vs 4.5%,P0.05） were similar between culture-negative and culture-positive peritonitis.Conclusion：Culture-negative Peritonitis In Peritoneal Dialysis Patients may suggest bad prognosis,and the history of previous antibiotic treatment was one of reasons.