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目的观察腹膜透析置管术后预防性应用抗生素是否影响休整期腹膜炎的发生。方法回顾性分析我院2011年1月至2012年12月接受腹膜透析患者53例,其中男性29例,女性24例,年龄26～83岁,平均年龄(63.9±12.83)岁。根据腹透置管术后的封管方式分为两组,A组33例,术后给予腹透液500ml冲洗腹腔,并应用20mg肝素加200ml腹透液中灌注腹腔封管。B组20例,术后以相同的方法冲洗腹腔后,应用20mg肝素加头孢唑啉1.0g加200ml腹透液中灌注腹腔,如头孢唑啉过敏者应用庆大霉素4万U。腹膜透析时观察腹膜透出液的性质、透明度等,对可疑患者立即留取存腹4h腹膜透出液标本进行常规检查,并同时留取标本进行细菌学培养。结果 A组33例中发生腹膜炎6例,占18%,B组20例中发生腹膜炎1例,占5%,两组间比较差异无统计学意义(P>0.05)。结论术后腹腔应用抗生素对于预防休整期腹膜炎是否有意义,有待进一步探讨。
Objective To observe whether prophylactic antibiotics after peritoneal dialysis catheter treatment affect the occurrence of peritonitis during rest period. Methods A retrospective analysis of 53 patients with peritoneal dialysis in our hospital from January 2011 to December 2012, including 29 males and 24 females, aged from 26 to 83 years old with an average age of 63.9 ± 12.83 years. According to the method of sealing after peritoneal catheterization, the patients were divided into two groups. Group A (33 cases) received intraperitoneal peritoneal dialysis (500ml) after peritoneal lavage and peritoneal tube was perfused with 20mg heparin and 200ml peritoneal fluid. Group B, 20 cases, after the same method of washing the peritoneal cavity, the application of 20mg heparin plus cefazolin 1.0g plus 200ml peritoneal fluid peritoneal perfusion, such as cefazolin allergy use gentamicin 40,000 U. Peritoneal dialysis observed the nature of peritoneal dialysis fluid, transparency, etc., suspicious patients immediately deposit 4h peritoneal dialysis fluid samples for routine examination, and at the same time specimens were taken for bacteriological culture. Results Peritonitis occurred in 6 of 33 cases (18%) in group A and 1 case of peritonitis in group B (5%). There was no significant difference between the two groups (P> 0.05). Conclusion Postoperative intraperitoneal antibiotics for the prevention of rest stage peritonitis is meaningful to be further explored.