比较换药与不换药对慢性非卧床腹膜透析患者出口处感染和腹膜炎的影响。

Comparing the Effect of Dressing Versus No-dressing on Exit Site Infection and Peritonitis in Chronic Ambulatory Peritoneal Dialysis Patients.

作者信息

Taheri Shahram, Ahmadnia Mahdieh, Mortazavi Mojgan, Karimi Shirin, Reihani Homa, Seirafian Shiva

机构信息

Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Isfahan Kidney Diseases Research Center, Peritoneal Dialysis Ward, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Adv Biomed Res. 2017 Jan 31;6:5. doi: 10.4103/2277-9175.199263. eCollection 2017.

DOI:10.4103/2277-9175.199263

PMID:28217650

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5309448/

Abstract

BACHGROUND

Peritonitis and exit site (ES) infection are two main complications of peritoneal dialysis. There are some controversies regard to preventive strategies for ES care. In this study we compared peritonitis and ES infection rates in patients with and without dressing.

MATERIALS AND METHODS

This historical cohort study carried out on 72 patients under continuous ambulatory peritoneal dialysis treatment, 54 with dressing versus 18 patients without dressing, followed from October 1, 2010 to March 31, 2011 for peritonitis and ES infection.

RESULTS

A total of 17 episodes of ES infection occurred in 12 patients in dressing group, but no case was seen in no-dressing group ( = 0.02). Twenty-one episodes of peritonitis occurred in 15 patients in both groups (one episode every 20.6 patient-months). In no-dressing group two episodes occurred in only one patient (one episode every 54 patient-months), and in dressing group, 19 episode in 14 patients (one episode every 17.1 patient-months) ( = 0.03). Peritonitis was significantly more frequent in male versus female in overall patients (38% vs. 14%, = 0.025) and in dressing group (52% vs. 15%, = 0.003). In dressing group, peritonitis was more frequent in diabetics versus non-diabetics (48% vs. 11%, = 0.01). Odds ratio for developing peritonitis was 9.4 in dressing group (95% confidence interval [CI] =1.05 - 84.4; = 0.045), and 4.4 in men (95% CI = 1.26 - 15.19; = 0.02).

CONCLUSION

In this study, chronic ES care without dressing was associated with lower risk of peritonitis and ES infection.

摘要

背景

腹膜炎和出口处（ES）感染是腹膜透析的两个主要并发症。关于ES护理的预防策略存在一些争议。在本研究中，我们比较了有敷料和无敷料患者的腹膜炎和ES感染率。

材料与方法

这项历史性队列研究对72例持续非卧床腹膜透析治疗的患者进行，其中54例有敷料，18例无敷料，从2010年10月1日至2011年3月31日随访腹膜炎和ES感染情况。

结果

有敷料组12例患者共发生17次ES感染，无敷料组未观察到病例（P = 0.02）。两组15例患者共发生21次腹膜炎（每20.6患者月发生1次）。无敷料组仅1例患者发生2次（每54患者月发生1次），有敷料组14例患者发生19次（每17.1患者月发生1次）（P = 0.03）。总体患者中男性腹膜炎发生率显著高于女性（38%对14%，P = 0.025），有敷料组中也是如此（52%对15%，P = 0.003）。在有敷料组中，糖尿病患者腹膜炎发生率高于非糖尿病患者（48%对
11%，P = 0.01）。有敷料组发生腹膜炎的比值比为9.4（95%置信区间[CI]=1.05 - 84.4；P = 0.045），男性为4.4（95% CI = 1.26 - 15.19；P = 0.02）。