Topanthanont Suthida, Sakulsaengprapha Amporn
Division of Nursing Service, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Sep;94 Suppl 4:S25-9.
This single center retrospective cohort study was conducted to assess peritonitis rate during 2000 to 2010.
All 103 peritoneal dialysis (PD) patients during January 2000 to December 2010 were recruited in the present study.
There were 112 episodes ofperitonitis during 5,238 patient-month which was 1 episode ofperitonitis in 46.77 patient-month or 0.257 episode per patient-year. Fifty-eight patients used the previous single bag dialysis solution (both safe lock and spike system). During 2003-2005, 35 (60%) patients who previously used the single bag system were retrained and changed to new double bags connecting system while the remainings were out of program before this system was available in the hospital. After the new double bags connecting systems and automated peritoneal dialysis (APD) were available, 71 and 7 new patients were commenced on double bags system andAPD respectively. The authors found 66 peritonitis during 2,686 months in the group of patients who used single bag solution which was equall to 1 episode of peritonitis in 40.70 patient-months or 0.295 peritonitis per patient-year. In the double bags solution group, there were 45 episodes of peritonitis during 2,722 months which equalled 1 peritonitis in 60.49 patient-months or 0.198 peritonitis per patient-year, while the authors found I episode of peritonitis in 88 patient-month or 0.136 peritonitis per patient-year. In the present study, there were 38 (36.9%) diabetic patients. There were 35 and 77 episodes of peritonitis within 1,141 and 4,355patient-months which means 1 episode of peritonitis every 32.60 and 56.56 months or 0.368 and 0.212 peritonitis perpatient-year in diabetic and non diabetic patients respectively.
The authors confirmed that diabetes mellitus was the risk factor of peritonitis in the authors unit. With the new double bags connecting system and APD, peritonitis rate in the authors unit decreased significantly. Peritonitis rate in the authors unit was 0.257 episode per patient-year or 1 episode every 46.77 patient-months which achieved the goal standard.
本单中心回顾性队列研究旨在评估2000年至2010年期间的腹膜炎发生率。
本研究纳入了2000年1月至2010年12月期间的所有103例腹膜透析（PD）患者。
在5238个患者月期间共发生112次腹膜炎发作，即每46.77个患者月发生1次腹膜炎发作，或每名患者每年发生0.257次发作。58例患者使用过之前的单袋透析液（安全锁和穿刺系统）。在2003 - 2005年期间，35例（60%）之前使用单袋系统的患者接受了再培训并更换为新的双袋连接系统，而其余患者在该系统在医院可用之前就退出了项目。在新的双袋连接系统和自动化腹膜透析（APD）可用后，分别有71例和7例新患者开始使用双袋系统和APD。作者发现，使用单袋透析液的患者组在2686个月内发生66次腹膜炎发作，即每40.70个患者月发生1次腹膜炎发作，或每名患者每年发生0.295次腹膜炎发作。在双袋透析液组中，在2722个月内发生45次腹膜炎发作，即每60.49个患者月发生1次腹膜炎发作，或每名患者每年发生0.198次腹膜炎发作，而作者发现每88个患者月发生1次腹膜炎发作，或每名患者每年发生0.136次腹膜炎发作。在本研究中，有38例（36.9%）糖尿病患者。在1141个和4355个患者月内分别发生35次和77次腹膜炎发作，这意味着糖尿病患者和非糖尿病患者分别每32.60个月和56.56个月发生1次腹膜炎发作，或每名患者每年分别发生0.368次和0.212次腹膜炎发作。
作者证实糖尿病是本单位腹膜炎的危险因素。随着新的双袋连接系统和APD的使用，本单位的腹膜炎发生率显著降低。本单位的腹膜炎发生率为每名患者每年0.257次发作，或每46.77个患者月发生1次发作，达到了目标标准。
