短期和长期腹膜透析患者导管相关感染发生率的比较

摘要

Tostudythetunnelinfectionrate,exit-siteinfectionratedifferencebetweenperitonealdialysispa-tients( PD)≥4 years and patients who died or changed from peritoneal dialysis to hemodialysis patients in 4 years. Methods:Collection 1996-2012 medical records of the PD patient's outcomes and infection( prospective since 1993). Patients were di-vided into two groups:continuous ambulatory peritoneal dialysis( CAPD ),continuous cycle peritoneal dialysis( CCPD )≥4 years patients(n=43,referred to as≥4 years group),conduct CAPD,CCPD less than 4 years patients(died or changed to he-modialysis,n=213,referred to ﹤4 years group). Observed the export infection prevalence,tunnel infection prevalence due to a variety of pathogenic microorganisms cause of Peritoneal dialysis patients were during. Results:The incidence of exit site infec-tion in ﹤4 years group and≥4 year group was1. 2 times/year and 0. 7 times/year(P﹤0. 000 1),respectively,difference is partly due to Staphylococcus aureus(0. 45 times/year and 0. 3 times/year,P﹤0. 001),and other Gram-positive bacteria (0. 28 times/year and 0. 10 times/year,P﹤0. 001),the tunnel infection rates of two group are same(0. 2 times/year). Con-clusion:Although the infection rates of ≥4 years group is lower,staph infections accounted for a higher proportion,Need for improved infection prevention techniques to improve dialysis patient survival,Improved dialysis techniques are needed in order to prevent infection and improve survival.%目的：研究患者腹膜透析（ PD）≥4年与4年内死亡或改为血液透析的患者出口感染、隧道感染发生率的区别。方法：收集1996年-2012年PD患者有关的感染和转归病历资料（前瞻性自1993年以来），患者分为两组：持续性不卧床腹膜透析（ CAPD）、持续性循环腹膜透析（ CCPD）≥4年以上患者组（ n=43，简称≥4年组），进行CAPD， CCPD不到4年死亡或改为血液透析的患者组（ n=213，简称﹤4年组）。观察由于各种病原微生物导致两组患者腹膜透析过程中出口感染、隧道感染的感染率。结果：﹤4年组与≥4年组出口部位感染者分别为1.2次/人·年和0.7次/人·年（P﹤0.0001），差异部分是由于金黄色葡萄球菌（每年0.45次和每年0.3次，P﹤0.001）和其他革兰阳性菌（0.28次/人·年和0.10次/人·年，P﹤0.001）造成的。两组的隧道感染率相同（每年0.2次）。结论：虽然≥4年组感染率较低，但其中金黄色葡萄球菌感染比例较高，临床需要改良透析技术预防感染，以提高患者生存率。