跨領域之衛教改善腹膜透析病患預後之角色

Multidisciplinary Predialysis Education Improves Outcome of Peritoneal Dialysis Patients

許程凱(Cheng-Kai Hsu) ； 李進昌(Chin-Chan Lee) ； 陳奕廷(Yih-Ting Chen) ； 孫樵隱(Chiao-Yin Sun) ； 陳俊宇(Chun-Yu Chen) ； 許恆榮(Heng-Jung Hsu) ； 陳永昌(Yung-Chang Chen) ； 吳逸文(I-Wen Wu)

《腎臟與透析》 31卷1期 (2019/03) Pp. 14-20

https://doi.org/10.6340/KD.201903_31(1).0004

摘要

跨領域之衛教（multidisciplinary predialysis education, MPE）對於未來接受腹膜透析病人的效果仍未明。我們收集腹膜透析的病人，比較接受MPE與否的腹膜炎發生率和腹膜炎死亡率，以及未發生腹膜炎存活曲線和預後因子。MPE組比起非MPE組有較低的腹膜炎發生率。非MPE及MPE組發生第一次腹膜炎的中位數時間分別為33.9個月和46.7個月。MPE是未發生腹膜炎的獨立預測因子。標準化的MPE能延長第一次腹膜炎發生的時間，降低腹膜炎發生率及腹膜炎死亡率。

關鍵字

腹膜透析 ； 腹膜炎 ； 跨領域之衛教

並列摘要

Multidisciplinary predialysis education (MPE) has shown improvement in outcomes of chronic kidney disease (CKD) patients. However, the legacy effects of MPE in peritoneal dialysis (PD) patients remain unclear. All patients who start PD at single hospital in 2007-2016 were enrolled. The incidence of peritonitis and peritonitis-related mortality were compared between MPE recipients and non-recipients. Kaplan-Meier analysis and Cox proportional hazards model were applied to identify the prognostic factors associated with peritonitis-free survival. The patients of MPE group had a lower peritonitis rate compared with the non-MPE group. The median time to the first episode of peritonitis in the non-MPE and MPE groups was 33.9 months and 46.7 months, respectively. Cox regression analysis revealed that MPE assignment were significant independent predictors for peritonitis-free survival. An efficient standardized MPE program may prolong the time to the first episode of peritonitis and reduce peritonitis rate, independent of age, gender, diabetes, hypertension, educational status, and PD modality. Subsequently, it decreased peritonitis-related death.

並列關鍵字

peritoneal dialysis ； peritonitis ； multidisciplinary predialysis education