Abstract:

Objective To investigate the status of exit-site care among peritoneal dialysis patients through a multicenter survey in Beijing and Shenzhen,and to analyze the influencing factors of patients’ exit-site care practice. Methods A self-designed questionnaire was used to investigate the exit-site care practice of 1,204 peritoneal dialysis patients who were followed up regularly in 12 peritoneal dialysis centers from Beijing and Shenzhen. The practice of exit-site care was divided into 5 dimensions:aseptic technique,assessment of exit-site,dressing change,catheter protection method and catheter fixation,with a full score of 50. Results The general score of exit-site care of 1,204 peritoneal dialysis patients in Beijing and Shenzhen was 44.76±5.85,while the scores of exit-site assessment and aseptic technique were relatively low. Univariate analysis showed that with or without history of exit-site infection,different operators and different locations of catheter outlet had different scores of exit-site care practice（P<0.05）. Multiple linear regression results showed that the factors influencing the general score of exit-site care practice were dialysis duration,infection history,dressing change operator,patient education level and catheter outlet location with an order from high to low. Conclusion The practice status of exit-site care in peritoneal dialysis patients from Beijing and Shenzhen was generally acceptable,while the practice of exit-site care assessment and aseptic technique were relatively poor. Further retraining would be needed,especially for patients with long dialysis time and a history of infection.

Key words: Peritoneal Dialysis, Catheter Related Infection, Exit-Site Care, Self Care

摘要：

目的 调查北京市和深圳市多所腹膜透析中心患者导管外出口护理的现状,并分析影响患者导管外出口护理行为的原因,为做好临床腹膜透析患者的培训提供依据。 方法 采用自制问卷对北京市及深圳市12所腹膜透析中心门诊随访的1 204例腹膜透析患者的导管外出口护理情况进行调查。结果 北京市和深圳市腹膜透析患者导管外出口护理得分为（44.76±5.85）分,导管外出口评估和无菌技术得分偏低。单因素分析显示,有无导管外出口感染史、不同换药操作者、不同导管外出口位置、不同文化程度、不同透析龄的患者导管外出口护理得分的比较,差异有统计学意义（P<0.05）。多元线性回归分析显示,影响导管外出口护理得分的因素为透析龄、导管外出口感染史、换药操作者、文化程度及导管外出口位置。结论 腹膜透析患者导管外出口护理得分尚可,但导管外出口评估和无菌技术得分较低,仍需进一步加强培训,尤其是对透析龄长、有感染史的患者。

关键词: 腹膜透析, 导管相关性感染, 导管外出口护理, 自我护理