更换短管对腹透相关性腹膜炎预后的影响

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目的探讨更换短管与否对腹透相关性腹膜炎预后的影响。方法采取前瞻性随机对照的研究方法,将我院2008年1月至2011年1月收治的83例腹透相关性腹膜炎患者随机分为观察组(更换短管组38例)与对照组(不更换短管组45例),两组患者在发生腹膜炎时均由同一腹透护士行腹腔冲洗至腹透液清亮后,观察组予更换腹膜透析短管,对照组不予更换短管,再均按国际腹膜透析学会腹膜炎治疗指南规范使用抗生素,比较两组患者腹膜炎症状改善时间、半年内腹膜炎复发率有无差异。结果观察组38例中3例拔除腹膜透析管,拔管率为7.89%,半年内11例复发(28.94%),腹透液清亮时间为(5.18±4.41)d,腹痛消失时间为(3.03±2.94)d;对照组45例中5例拔除腹膜透析管,拔管率为11.11%、半年内12例复发(26.66%),腹透液清亮时间为(5.09±3.59)d,腹痛消失时间为(2.73±2.93)d;拔管率、腹膜炎复发率、腹透液清亮时间、腹痛消失时间两组比较差异均无统计学意义(均P>0.05)。结论发生腹透相关性腹膜炎时更换短管与否对腹透相关性腹膜炎预后无明显影响。不予更换短管可减少护士的工作量,并降低患者的医疗费用。 Objective To investigate the effect of short tube replacement on the prognosis of peritonitis-associated peritonitis. Methods A prospective randomized controlled study was conducted in 83 patients with peritoneal-related peritonitis admitted from January 2008 to January 2011 in our hospital. The patients in the observation group (replacing the short tube group) and the control group Replace the short tube group of 45 cases), two groups of patients in the occurrence of peritonitis by the same peritoneal nurse to perform peritoneal lavage clear, the observation group to replace the peritoneal dialysis short tube, the control group not to replace the short tube, According to the International Peritoneal Dialysis Society guidelines for the treatment of peritonitis using antibiotics, peritonitis symptoms were compared between two groups to improve the time, within six months the recurrence rate of peritonitis with or without difference. Results In the observation group, 3 cases of the peritoneal dialysis tube were removed in 3 of 38 cases, the rate of extubation was 7.89%, the recurrence rate was 11.9% within 6 months, the time of clearing the peritoneal fluid was (5.18 ± 4.41) d, the disappearance time of abdominal pain was (3.03 ± 2.94) d. In the control group, 5 cases of peritoneal dialysis tube were removed in 5 cases, the rate of extubation was 11.11%, 12 cases relapsed within 6 months (26.66%), the peritoneal liquid clear time (5.09 ± 3.59) d, (2.73 ± 2.93) d. There were no significant differences in extubation rate, peritonitis recurrence rate, peritoneal fluid clearing time, and disappearance of abdominal pain between the two groups (all P> 0.05). Conclusion In the event of peritonitis-related peritonitis, the replacement of the short tube or not has no effect on the prognosis of peritonitis-associated peritonitis. Failure to replace the stubs can reduce the workload of nurses and reduce the patient’s medical costs.
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