目的 探讨腹膜透析患者发生腹膜炎的相关因素,分析原因并寻找对策,为腹膜炎的防治提供依据.方法 调查分析2015年5月至2016年5月期间,在武汉市中心医院肾病风湿科进行持续性非卧床腹膜透析治疗的患者72例,其中19例患者发生腹膜炎症状.将72例患者分别按年龄、发病季节、文化程度、基础疾病等类别进行分组,通过收集各组别之间发生腹膜炎及再次复发等数据,运用统计学方法进行比对分析,比较各组别之间的统计学差异.结果 持续性非卧床腹膜透析患者随着年龄的增长,发生腹膜炎的概率呈上升趋势(30岁以下为11.1％,60岁以上为40.0％).每年5～10月份患者发生腹膜炎的概率(37.1％)明显高于其他月份发病者(16.2％),差异有统计学意义(P＜0.05).文化程度在初中以下者发生腹膜炎的概率(45.8％)明显高于初中及以上文化者(16.7％),差异有统计学意义(P＜0.05).基础疾病为糖尿病的患者在腹膜透析过程中发生腹膜炎的概率(52.4％)明显高于其他非糖尿病患者(高血压16.7％、肾小球肾炎15.6％),差异有统计学意义(P＜0.05).结论 经过统计分析,获得腹膜透析并发腹膜炎的相关因素有年龄、发病季节、患者的文化程度以及是否伴有糖尿病等.针对上述相关因素,在临床工作中,对于慢性肾衰竭患者在进行腹膜透析治疗之前,应做好预防发生腹膜炎的工作,在术后应强化患者的规范化操作培训,重点讲解操作过程中的注意事项,使患者养成良好的生活习惯,并嘱患者定期参加本院的健康教育讲堂,积极配合医院方面的信息回访,尽可能地降低发生腹膜炎的概率,提高患者生活质量.若腹膜炎已经发生,则应尽早对症处理,以免影响患者的预后.%Objective To study the related factors of peritonitis in patients with continuous ambulatory peritoneal dialysis (CAPD),and analyze reasons and seek countermeasures,in order to provide evidence for the prevention of peritonitis.Methods During the period of May 2015 to May 2016 in Wuhan Central Hospital,72 cases of CAPD due to chronic renal failure were studied,including 19 patients with symptoms of peritonitis.Seventy-two patients were grouped according to the age,onset season,education level,and basic diseases.The data about peritonitis and recurrence were analyzed comparatively and statistically.Results The incidence of peritonitis in CAPD patients was increased with age (＜30 years old:11.1％;＞60 years old:40.0％);The incidence of peritonitis from May to October each year was significantly higher (37.1％) than that in other seasons (16.2％) (P＜0.05).The incidence of peritonitis in those with the junior high school below was significantly higher (45.8％) than that in those with the junior high school and above (16.7％) (P＜0.05).The incidence of peritonitis in diabetes patients receiving CAPD was significantly higher (52.4％) than in those without diabetes (16.7％ or 15.6％) (P＜0.05).Condusions Statistically,the related factors of peritonitis following CAPD include age,seasons,the education level and diabetes.According to the correlative factors in clinical work,before the peritoneal dialysis treatment for chronic renal failure patients,we should do a good job in prevention of peritonitis in patients with postoperative which should strengthen the standardization of the operation training,we must focus on the matters needing attention in the process of operation,the patients will develop good habits and customs,and instruct patients on a regular basis to participate in our health education lecture hall,actively cooperate with the hospital information back,as far as possible to reduce the probability of peritonitis,improve patient quality of life.If peritonitis has already occurred,we should suit the processing as soon as possible,in order not to affect the prognosis of patients.
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