| Objective:Taking the clinical data of patients with peritoneal dialysis associated peritonitis(PDAP)in the Dialysis Center of Hunan Provincial People’s Hospital as the research object,the purpose is to observe whether there is a difference in curative effect between the two groups of patients who received and did not receive abdominal irrigation,providing a reasonable basis for clinical treatment.Methods:Retrospective analysis was conducted on 169 cases of peritoneal dialysis patients with peritonitis from January2014 to July 2020 in our center.According to the inclusion criteria(diagnostic criteria for peritonitis associated with peritoneal dialysis in ISPD guidelines)and exclusion criteria,clinical data of 88 PDAP patients were included.According to whether to perform irrigation,they were divided into 30 cases in the conventional group(combined medication according to ISPD guidelines)and 58 cases in the irrigation group(conventional treatment plan combined with abdominal cavity irrigation).The general information,blood biochemical examination results,peritonitis indicators,etc.Statistical analysis was conducted on the data collected above,and the data collected above were statistically analyzed to compare the difference in curative effect between the two groups of patients who received abdominal irrigation and those who did not.Results:1.In the conventional group,there were 12 males and 18 females.The average dialysis age of the patients was50.61±11.58 years.The average dialysis age was 38.4±29.76 months.In the Peritoneal lavage,there were 20 males and 38 females,the average dialysis age of the patients was54.78±13.89 years.The average dialysis age was 35.38±32.63 months.There was no statistically significant difference in general information between the two groups(P>0.05).There was no statistical significance in the total number of white blood cells,white blood cells in ascites,albumin,CRP,PCT and other blood biochemical indexes between the two groups(P>0.05).2.In the routine group,the positive rate of pathogen culture was 73.3%(22/30),of which 86.4%(19/22)were grampositive bacteria,and 13.6%(3/22)were gram-negative bacteria.In the flushing group,the positive rate of pathogenic bacteria culture was 67.2%(39/58),of which 64.1%(25/39)were gram-positive bacteria,including one case of methicillin-resistant Staphylococcus aureus(MRSA).The proportion of gram-negative bacteria was 35.9%(14/39).There was no statistically significant difference in the composition ratio of the bacterial spectrum between the two groups(P>0.05).3.The cure rate in the routine group was 70.0%(21/30),and the withdrawal rate was 30.0%(9/30).In the flushing group,the cure rate was 74.1%(43/58),and the withdrawal rate was 25.9%(15/58).The difference in cure rate and withdrawal rate between the two groups was not statistically significant(P>0.05).4.Before the initial treatment,there was no difference in the total number of white blood cells in the first ascites between the routine group and the irrigating group.Compared with the total number of white blood cells in the first ascites,the decrease ratio of the total number of white blood cells in the ascites of the rinsing group.and the conventional group was statistically significant in two groups(P<0.05).5.In the routine group,the cure rate of gram-positive peritonitis was 68.4%(13/19),and the cure rate of gramnegative peritonitis was 66.7%(2/3).In the flushing group,the cure rate of gram-positive peritonitis was 76.0%(19/25),and the cure rate of gram-negative peritonitis was 71.4%(10/14).results were of certain significance in the cure rate of the bacteria between the two groups(P>0.05).6.For cured PDAP patients,after 2 months of follow-up,The in the rebound phenomenon rate of peritonitis within 2months was 9.5%(2/21),in the conventional group compared with 4.7%(2/43)in the irrigated group.But there was no statistical difference in the recurrence rate between the two groups(P>0.05).Conclusion:1.Peritoneal irrigation could not improve the cure rate of peritoneal dialysis associated peritonitis.2.Peritoneal irrigation is helpful to quickly reduce inflammation in the abdominal cavity.3.Peritoneal irrigation does not reduce the recurrence of peritonitis in PDAP patients. |
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