标题:
Effects of seasonal changes on peritoneal dialysis related peritonitis in peritoneal dialysis patients
讲者:
赵慧萍
单位:
北京大学人民医院
播放:
1693
论文摘要:
Objectives to investigate the effect of seasonal changes on peritoneal dialysis(PD)-related peritonitis, and provide evidence for clinical prevention and treatment.
Methods We reviewed all episodes of PD-related peritonitis from Jan 1st, 2007 to Dec 31st, 2015 in our hospital. Record and analyze the incidence of peritonitis, laboratory indexes, pathogens and clinical outcome in different seasons.
Results (1)During nine years, 119 PD patients occurred 190 times of peritonitis. The incidence of peritonitis in four seasons were significantly different (P<0.05). The incidence of peritonitis in summer and autumn were significantly higher than other seasons. Since 2009, the incidence of peritonitis in summer in each year was higher than other seasons(P<0.05).(2)Peritonitis induced by Gram-positive and Gram-negative bacteria in summer and autumn were higher than other seasons. The major Gram-positive bacteria was coagulase-negative staphylococci(CoNS), the major gram-negative bacteria is Escherichia coli. There was no statistical difference in the distribution of pathogen among peritonitis in different seasons. The main causes of peritonitis in autumn and summer were related to PD operation, significantly more than that in winter and spring. Diarrhea or constipation was the second major cause, the highest proportion was in summer and autumn. (3) 171 cases were treatment effective, cure rate was 90%. The cure rate of peritonitis in winter was the highest in four seasons, the cure rate in summer and spring were low(P<0.001). In peritonitis of treatment failure, 42.1% occurred in summer, higher than other seasons.
Conclusions There is some relationships between PD-related peritonitis and season, the incidence of peritonitis in summer and autumn were significantly higher, CoNS and gram-negative bacteria were the main pathogens. The outcomes of peritonitis in summer is relatively poor, we should pay more attention to peritonitis in summer, continue to strengthen the standardized operation and prevent intestinal diseases, so as to reduce the incidence of peritonitis.