Fang Pan, Lu Jia, Liu Ying-Hong, Deng Hong-Mei, Zhang Lei, Zhang Hong-Qing
Department of Nephrology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, China.
Institute of Nephrology, Central South University, Changsha, 410011, Hunan, China.
Int Urol Nephrol. 2018 Jun;50(6):1163-1170. doi: 10.1007/s11255-018-1823-z. Epub 2018 Mar 5.
Peritonitis, which is one of the leading complications of peritoneal dialysis (PD) worldwide, severely affected morbidity and mortality of the PD patients. Although many efforts have been made to prevent PD-related peritonitis, it seems impossible to prevent it completely. Many causes have been reported to lead to peritonitis, and contamination during bag exchange is one of the important risk factors for peritonitis.
Here, we introduce an operating vehicle, which we invented to provide a sterile and safe space for bag exchange. A single-center, retrospective, case-control study was undertaken to determine whether this operating vehicle has a protective role in preventing peritonitis. In total, 462 continuous ambulatory peritoneal dialysis patients were included in this study from October 2014 to March 2017. According to their personal will, these patients chose to use operating vehicle or traditional method during their bag exchange. The demographic, clinical and laboratory data of these patients in the two groups were collected, analyzed and compared.
Of 462 patients with home dialysis, operating vehicle group consisted of 61 patients, and control group consisted of 401 patients. In the control group, over 677 patient-years, peritonitis occurred in 69 of 401 patients (17.2%), while in the operating vehicle group, over 60 patient-years, only 4 of 61 patients (6.6%) had episodes of peritonitis. The number of patients suffered from peritonitis was significantly decreased in the operating vehicle group (P = 0.034). Besides, there were a total of 99 episodes of peritonitis, and the rate was 1 episode every 7.2 patient-years in control group and 1 episode every 12 patient-years in the operating vehicle group. There was significant difference between the two groups (0.013). Positive dialysate cultures were obtained in majority of the peritonitis episodes (60.6%).
Operating vehicle might help to reduce PD-related peritonitis by preventing contamination during bag exchange. Further studies are still needed to demonstrate the protective role of the operating vehicle in preventing peritonitis.
腹膜炎是全球腹膜透析（PD）的主要并发症之一，严重影响PD患者的发病率和死亡率。尽管已经做出了许多努力来预防与PD相关的腹膜炎，但似乎不可能完全预防。据报道，许多原因可导致腹膜炎，而换袋过程中的污染是腹膜炎的重要危险因素之一。
在此，我们介绍一种我们发明的操作车，用于为换袋提供无菌和安全的空间。进行了一项单中心、回顾性、病例对照研究，以确定这种操作车在预防腹膜炎方面是否具有保护作用。2014年10月至2017年3月，共有462例持续性非卧床腹膜透析患者纳入本研究。根据他们的个人意愿，这些患者在换袋时选择使用操作车或传统方法。收集、分析和比较两组患者的人口统计学、临床和实验室数据。
在462例家庭透析患者中，操作车组有61例患者，对照组有401例患者。在对照组中，在超过677患者年的时间里，401例患者中有69例（17.2%）发生腹膜炎，而在操作车组中，在超过60患者年的时间里，61例患者中只有4例（6.6%）发生腹膜炎。操作车组发生腹膜炎的患者数量显著减少（P = 0.034）。此外，共有99次腹膜炎发作，对照组的发生率为每7.2患者年1次，操作车组为每12患者年1次。两组之间存在显著差异（0.013）。大多数腹膜炎发作（60.6%）获得了阳性透析液培养结果。
操作车可能有助于通过防止换袋过程中的污染来减少与PD相关的腹膜炎。仍需要进一步的研究来证明操作车在预防腹膜炎方面的保护作用。
