当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2013年
4期
50-51
,共2页
腹膜透析%腹膜炎%培养阴性
腹膜透析%腹膜炎%培養陰性
복막투석%복막염%배양음성
Peritoneal dialysis%Peritonitis%Culture-negative
目的探讨腹膜透析相关性腹膜炎培养阴性的影响因素及治疗方案.方法回顾性分析62例共98例次腹膜透析相关性腹膜炎患者,对比分析培养阴性及阳性腹膜透析相关性腹膜炎的近期抗生素使用情况、临床特点及治疗效果.结果62例共98例次腹膜透析相关性腹膜炎患者,培养阳性者73例次(74.4%),培养阴性者25例次(25.5%).与培养阳性者相比,培养阴性者具有更高的近期抗生素使用史(28% vs 10%,P<0.05),两者在治愈率(84% vs 79.4%)、拔管率(8% vs 8.2%)及复发率(8% vs 12.3%)方面,差异无统计学意义(P>0.05);培养阴性腹膜透析相关性腹膜炎应用万古霉素组治愈率最高(100%),应用环丙沙星组治愈率最低(66.6%).结论近期抗生素使用史是导致腹膜透析相关性腹膜炎腹透液培养阴性的主要原因之一,培养阴性患者可能以革兰氏阳性菌感染为主,治疗上以万古霉素效果最理想.
目的探討腹膜透析相關性腹膜炎培養陰性的影響因素及治療方案.方法迴顧性分析62例共98例次腹膜透析相關性腹膜炎患者,對比分析培養陰性及暘性腹膜透析相關性腹膜炎的近期抗生素使用情況、臨床特點及治療效果.結果62例共98例次腹膜透析相關性腹膜炎患者,培養暘性者73例次(74.4%),培養陰性者25例次(25.5%).與培養暘性者相比,培養陰性者具有更高的近期抗生素使用史(28% vs 10%,P<0.05),兩者在治愈率(84% vs 79.4%)、拔管率(8% vs 8.2%)及複髮率(8% vs 12.3%)方麵,差異無統計學意義(P>0.05);培養陰性腹膜透析相關性腹膜炎應用萬古黴素組治愈率最高(100%),應用環丙沙星組治愈率最低(66.6%).結論近期抗生素使用史是導緻腹膜透析相關性腹膜炎腹透液培養陰性的主要原因之一,培養陰性患者可能以革蘭氏暘性菌感染為主,治療上以萬古黴素效果最理想.
목적탐토복막투석상관성복막염배양음성적영향인소급치료방안.방법회고성분석62례공98례차복막투석상관성복막염환자,대비분석배양음성급양성복막투석상관성복막염적근기항생소사용정황、림상특점급치료효과.결과62례공98례차복막투석상관성복막염환자,배양양성자73례차(74.4%),배양음성자25례차(25.5%).여배양양성자상비,배양음성자구유경고적근기항생소사용사(28% vs 10%,P<0.05),량자재치유솔(84% vs 79.4%)、발관솔(8% vs 8.2%)급복발솔(8% vs 12.3%)방면,차이무통계학의의(P>0.05);배양음성복막투석상관성복막염응용만고매소조치유솔최고(100%),응용배병사성조치유솔최저(66.6%).결론근기항생소사용사시도치복막투석상관성복막염복투액배양음성적주요원인지일,배양음성환자가능이혁란씨양성균감염위주,치료상이만고매소효과최이상.
Objective To explore the influencing factors and treatment of culture-negative peritonitis in peritoneal dialysis patients. Methods 98 cases of peritonitis in peritoneal dialysis patients of 62 individuals were retrospectively contrasted. The culture-negative cases were compared with culture-positive cases in history of previous antibiotic used, clinical characteristics and treatment effect. Results Among 98 cases of peritonitis in peritoneal dialysis patients in 62 individuals,73 cases(74.4%)were cultured positive and 25 cases(25.5%)were cultured negative. The rate of previous antibiotic used in culture-negative cases was higher than culture-positive ones(28%vs. 10%,P<0.05). And the rate of cure(84%vs. 79.4%),catheter removal(8%vs. 8.2%), relapse(8%vs. 12.3%)were similar between culture-negative and culture-positive cases. The culture-negative peritonitis in peritoneal dialysis patients were susceptible (100%) to vancomycin, but the cure-rate of ciprofloxacin was lowest(66.6%). Conclusion The history of previous antibiotic used is one of the main reasons of culture-negative peritonitis in peritoneal dialysis patients. The culture-negative patients are mainly infected by gram-positive bacterial, and vancomycin is the best choice in treatment.
