目的 探讨实施腹透患者照护性参与自我管理,对降低其腹透相关性腹膜炎的效果。方法 选取2017年1月—2017年12月腹透门诊建档行规律随访的125例居家腹透患者作为对照组,采用常规门诊随访和健康教育指导。2018年1月—2018年12月腹透门诊建档行规律随访的130例居家腹透患者作为干预组,在常规门诊随访和健康宣教指导基础上实施腹透患者照护性参与自我管理,比较实施腹透患者照护性参与自我管理前后,两组患者腹透相关性腹膜炎的发生情况。结果 通过实施腹透患者照护性参与自我管理后,腹透相关性腹膜炎发生率由实施前70.38个病人月降为101.84个病人月,差异有统计学意义(P<0.05)。因操作性及肠源性导致发生腹透相关性腹膜炎也由实施前9例（7.2%）、10例（8.0%）分别下降至2例（1.5%）、2例（1.5%）,差异有统计学意义(P<0.05)。结论 实施腹透患者照护性参与自我管理,可提高患者的依从性,提高患者更换腹膜透析液操作的规范性,降低患者因操作性及肠源性导致的腹透相关性腹膜炎的发生率,使患者的生存及生活质量得到提高。

Objective To investigate the effect of caregiving participatory self-management on reducing pertioneal dialysis-associated peritonitis in patients with peritonitis. Methods A group of 125 patients with home-based peritoneal dialysis from January 2017 to December 2017 were enrolled into the observation group, and adopted routine outpatient follow-up and health education guidance. Another group of 130 patients with home-based peritoneal dialysis from January 2018 to December 2018 were enrolled into the experimental group, and received caregiving participatory self-management on the basis of routine outpatient follow-up and health education guidance. The incidence of pertioneal dialysis-associated peritonitis was compared between the two groups. Results The incidence of pertioneal dialysis-associated peritonitis was significantly decreased from 70.38 patient months to 101.84 patient months after the implementation of caregiving participatory self-management (P<0.05). The incidence rates of pertioneal dialysis-associated peritonitis due to operational and enterogenous causes were also significantly decreased from 9 cases (7.2%) to 2 cases (1.5%) and from 10 (8.0%) cases to 2 cases (1.5%) respectively (P<0.05). Conclusion The implementation of caregiving participatory self-management can improve patient compliance and standarded peritoneal dialysate replacement, reduce the incidence of pertioneal dialysis-associated peritonitis caused by inappropriate operation or enterogenous causes, and finally increase the survival rate and quality of life of the patients.