Mendoza-Guevara L, Castro-Vazquez F, Aguilar-Kitsu A, Morales-Nava A, Rodriguez-Leyva F, Sanchez-Barbosa J L
Hospital de Pediatria, Centro Medico Nacional 'Siglo XXI', Instituto Mexicano del Seguro Social, Mexico, D.F., Mexico.
Contrib Nephrol. 2007;154:139-144. doi: 10.1159/000096959.
Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.
尽管随着断开系统的应用,发病率有所下降,但慢性肾衰竭患者的首要并发症仍是腹膜炎,其次是Tenckhoff导管出口部位感染。为降低出口部位感染发生率所做的一切努力都会降低腹膜炎发生的可能性。众所周知,儿科人群发生感染性并发症的风险很大,简化并安全地护理出口部位可预防随后发生的腹膜炎。本研究的目的是评估10%阿沐奇娜溶液与pH值中性肥皂相比,在预防慢性肾衰竭儿童出口部位感染方面的疗效。60例患者被随机分为两组。一组使用10%阿沐奇娜溶液每日清洁出口部位,另一组使用pH值中性肥皂,随访14个月。研究前,他们必须至少30天无感染。所有患者均由同一名护士指导如何清洁出口部位。两组在年龄、性别和透析时间方面几乎相同。肥皂组有9例感染,10%阿沐奇娜溶液组无感染,比值比为17(p = 0.004)。在这9例感染中,分离出的细菌为:铜绿假单胞菌引起4例(13%),金黄色葡萄球菌引起1例(3.3%),凝固酶阳性葡萄球菌引起2例(6.6%),粘质沙雷氏菌引起1例(3.3%)。总之,10%阿沐奇娜溶液可有效预防出口部位感染,且无任何局部继发反应。