腹膜透析腹膜炎的影响因素及短期预后分析*

Analysis of the risk factors and short-term prognosis of peritoneal dialysis peritonitis*

摘要:

目的 探讨腹膜透析腹膜炎的危险因素及短期预后。方法 选取2017年6月—2018年7月青海省人民医院收治的腹膜透析患者的76例为研究对象，根据感染发生情况设为感染组46例和对照组30例。分析腹膜炎的相关危险因素，观察记录单发腹膜炎和多发腹膜炎患者的治疗结局。结果 76例腹膜透析患者，未发生腹膜炎患者30例（39.47%），46例（60.53%）患者感染腹膜炎56例次，其中1例感染4次，2例感染3次，4例感染2次；单因素分析，两组患者性别构成比、原发疾病、体重指数、白细胞计数、血红蛋白、透析液浓度、透析龄比较，差异无统计学意义（P?>0.05）；两组年龄、文化水平、民族、高糖透析液使用、C反应蛋白、白蛋白、血钾比较，差异有统计学意义（P?<0.05）；经多因素一般非条件Logistic分析，年龄[OlR=1.893 （95% CI：1.512，3.026）]、文化水平低下[OlR=2.318（95% CI：1.389，3.225）]、民族[OlR=0.724（95% CI：0.389，0.895）、C反应蛋白水平[OlR=0.724（95% CI：0.389，0.895）]、白蛋白水平[OlR=1.595（95% CI：1.090，2.335）]、血钾水平[OlR=1.625（95% CI：1.079，2.449）]、高糖透析液使用[OlR=1.186（95% CI：0.822，1.710）]均是腹膜炎的危险因素；单发腹膜炎缓解例数多于多发腹膜炎（P?<0.05），多发腹膜炎患者拔管率及病死率高于单发性腹膜炎（P?<0.05）。结论 患者年龄、文化水平、民族、高糖透析液使用、C反应蛋白、白蛋白、血钾是腹膜透析发生腹膜炎的危险因素。多发性腹膜炎患者拔管率增加，预后差。临床根据患者自身情况进行干预可有效提高腹膜透析腹膜炎患者生存率。

Abstract:

Objective To investigate the risk factors and short-term prognosis of peritoneal dialysis peritonitis. Methods Seventy-six patients with peritoneal dialysis admitted to our hospital from June 2017 to July 2018 were enrolled. According to the infection, the risk factors of the infection group (n?=?46) and the control group (n?=?30) were analyzed. The outcome of treatment in patients with single peritonitis and multiple peritonitis were recorded. Results Among the 76 patients with peritoneal dialysis, 30 patients (39.47%) had no peritonitis, and 46 patients (60.53%) had 56 cases of peritonitis. One of them had 4 times of infections, 2 had 3 times of infections, and 4 had 2 times of infections. Univariate analysis showed no significant difference in gender, primary disease, body mass index, white blood cell count, hemoglobin, dialysate concentration, and dialysis age between the two groups (P?>?0.05); the differences of cultural level, age, ethnicity, albumin, the use of potassium, high glucose dialysate and C-reactive protein between 2 groups were statistically significant (P?