单中心腹膜透析相关性真菌性腹膜炎临床和预后分析

摘要

目的 探讨腹膜透析相关性真菌性腹膜炎(PDFP)的易感因素、诊治和预后,以提高真菌性腹膜炎的诊治水平.方法 回顾性分析惠州市中心人民医院腹膜透析中心2005年1月至2013年8月25例PDFP病例,分析患者的临床资料、病原体、治疗、预后.结果 PDFP占腹膜透析相关性腹膜炎的比例是7.89％; PDFP发生前4周使用过抗生素13例(52％);14例(56％)拔管后改为长期血液透析,死亡11例(44％);死亡组与存活组在糖尿病、血液透析、10d内拔管方面差异有统计学意义(P＜0.05).结论 使用抗生素是PDFP发生的危险因素,PDFP预后不良,确诊后早期拔管可降低死亡率.糖尿病、血液透析、10d内拔管是影响患者预后的因素.%Objective To investigate risk factors,diagnosis,treatment and prognosis of peritoneal dialysis-related fungal peritonitis (PDFP),and to improve the level of the diagnosis and treatment of fungal peritonitis.Methods We retrospectively reviewed 25 cases of PDFP in our hospital from January 2005 to August 2013,the clinical data,pathogens,treatment and prognosis of patients were analyzed.Results PDFP patients accounted for the proportion of patients with peritoneal dialysis related peritonitis was 7.89％.13 cases (52％) had a history of antibiotic use within 4 weeks before PDFP.14 cases (56％) withdrew peritoneal dialysis to hemodialysis,11 cases (44％) died.Diabetes,hemodialysis and catheter removal showed statistical significant difference in survival and dead groups (P ＜ 0.05).Conclusion The risk factors for PDFP identified in this study was the use of antibiotics.PDFP has poor prognosis and higher mortality,early catheter removal can help to decrease the mortality.Diabetes,hemodialysis,and catheter removal were factors influencing the prognosis of patients.