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术前风险因素对腹膜透析相关性腹膜炎的影响:日本单中心前瞻性研究。

The Impact of Preoperative Risk Factors on Peritoneal Dialysis-Related Peritonitis: A Single-Center Prospective Study in Japan.

机构信息

Division of Nephrology and Endocrinology, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Japan.

Department of Diabetes and Metabolism, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.

出版信息

Medicina (Kaunas). 2022 Feb 18;58(2):313. doi: 10.3390/medicina58020313.

Abstract

: Peritoneal dialysis (PD)-related peritonitis is a critical problem. However, preoperative risk factors for PD-related peritonitis have not been established. Thus, we aimed to determine the preoperative risk factors for PD-related peritonitis. : This is a single-center prospective observational study. All peritonitis episodes during the study period were recorded, and preoperative and intraoperative clinical parameters were compared between patients with and without peritonitis to examine risk factors for PD-related peritonitis. Furthermore, subcutaneous and abdominal fat volumes were evaluated using computed tomography. : Among a total of 118 patients, 24 patients developed peritonitis. The proportion of male patients (83% vs. 61%, = 0.04), body mass index (25 vs. 22 kg/m, = 0.04), and subcutaneous fat area (120 vs. 102 cm, = 0.01) were significantly higher and the proportion of patients living with family members (75% vs. 94%, = 0.02) was significantly lower in the peritonitis group than in the non-peritonitis group. There were no significant differences in age, operation method, surgeon experience, previous abdominal surgery, medical history of diabetic nephropathy, serum albumin level, and renal function between the two groups. : Male patients with high subcutaneous fat who are living alone might be at higher risk of PD-related peritonitis. These characteristics might be useful in risk assessment and patient education before PD induction.

摘要

腹膜透析(PD)相关腹膜炎是一个严重的问题。然而,PD 相关腹膜炎的术前危险因素尚未确定。因此,我们旨在确定 PD 相关腹膜炎的术前危险因素。

这是一项单中心前瞻性观察研究。记录研究期间所有腹膜炎发作,并比较腹膜炎患者和无腹膜炎患者的术前和术中临床参数,以检查 PD 相关腹膜炎的危险因素。此外,还使用计算机断层扫描评估皮下和腹部脂肪量。

在总共 118 名患者中,有 24 名患者发生腹膜炎。腹膜炎组男性患者的比例(83%比 61%, = 0.04)、体重指数(25 比 22 kg/m, = 0.04)和皮下脂肪面积(120 比 102 cm, = 0.01)明显较高,而腹膜炎组与无腹膜炎组相比,与家人一起生活的患者比例(75%比 94%, = 0.02)明显较低。两组患者的年龄、手术方法、外科医生经验、既往腹部手术史、糖尿病肾病病史、血清白蛋白水平和肾功能无显著差异。

单独生活的男性患者,皮下脂肪较多,可能有更高的 PD 相关腹膜炎风险。这些特征可能有助于 PD 诱导前的风险评估和患者教育。

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