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腹膜透析的出口处护理

Exit-site care in peritoneal dialysis.

作者信息

Wadhwa Nand K, Reddy Gampala H

机构信息

Division of Nephrology, Department of Medicine, School of Medicine, State University of New York at Stony Brook, Stony Brook, N.Y., USA.

出版信息

Contrib Nephrol. 2007;154:117-124. doi: 10.1159/000096955.

Abstract

Exit-site infection (ESI), tunnel infection and associated peritonitis are major causes of morbidity and catheter loss in chronic peritoneal dialysis patients. Meticulous exit-site care is vital in preventing ESI. Avoiding trauma to the exit-site and daily cleaning of the exit-site with a dedicated antimicrobial soap is essential for the longevity of the peritoneal dialysis catheter. Antibiotics cream and disinfectant agents including povidone-iodine, chlorhexidine, electrolytic chloroxidizing solutions (Amuchina 10% - ExSept Plus, Amuchina 5% - ExSept) are useful to keep the resident micro-organisms inhibited. ESI rates in peritoneal dialysis patients treated with Amuchina 10% (ExSept Plus) and Amuchina 5% (ExSept) for the exit-site care are similar or lower compared to povidone-iodine or chlorhexidine. Electrolytic chloroxidizing (Amuchina 10% - ExSept Plus and Amuchina 5% - ExSept) solutions for exit-site care are effective for prevention and treatment of ESI.

摘要

出口处感染(ESI)、隧道感染及相关腹膜炎是慢性腹膜透析患者发病和导管丢失的主要原因。细致的出口处护理对于预防ESI至关重要。避免出口处受到创伤以及每天用专用抗菌肥皂清洁出口处对于腹膜透析导管的长期使用至关重要。抗生素乳膏和消毒剂,包括聚维酮碘、氯己定、电解氯化溶液(10%的Amuchina - ExSept Plus、5%的Amuchina - ExSept),有助于抑制常驻微生物。与聚维酮碘或氯己定相比,使用10%的Amuchina(ExSept Plus)和5%的Amuchina(ExSept)进行出口处护理的腹膜透析患者的ESI发生率相似或更低。用于出口处护理的电解氯化(10%的Amuchina - ExSept Plus和5%的Amuchina - ExSept)溶液对ESI的预防和治疗有效。

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