心外科术后连续肾脏替代治疗患者医院感染危险因素及预后  

Prognosis and Risk Factors of Nosocomial Infection in Patients after Cardiac Surgery Requiring Continuous Renal Replacement Therapy

作　　者：杨勇[1] 贾士杰[1] 闫晓蕾[1] 陈英[1] 李小密[1] 胡尚基[1] 

机构地区：[1]首都医科大学附属北京安贞医院ICU北京市心肺血管疾病研究所,北京100029

出　　处：《中华医院感染学杂志》2010年第5期636-638,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨心脏外科手术后连续肾脏替代治疗患者医院感染及预后的危险因素。方法回顾性分析医院2006年1月～2007年12月的心外科术后连续肾脏替代治疗患者医院感染资料。结果两年来医院对125例心外科术后肾功能衰竭患者进行连续肾脏替代治疗,其中59例发生了医院感染,感染率为47.20%;分离病原菌158株,其中革兰阴性杆菌74株(46.84%),革兰阳性球菌58株(36.71%),真菌26株(16.46%);Logistic回归分析医院感染与术后机械通气时间(X1)、住院时间(X2)、住ICU时间(X3)有关,差异有统计学意义(χ2=48.642,P<0.01);医院感染组患者病死率为66.10%,非医院感染组病死率49.94%,两组病死率差异有统计学意义(χ2=6.168,P=0.013)。结论医院感染是心外科术后连续肾脏替代治疗患者死亡危险因素,提高患者生存率应控制医院感染。OBJECTIVE To investigate the prognosis and risk factors of nosocomial infection in hospitalized patients needing continuous renal replacement therapy （CRRT） after cardiac surgery. METHODS The clinical data of patients needing CRRT in our hospital from Jan 2006 to Dec 2007 were studied retrospectively. RESULTS There were 125 patients needing CRRT during the study period after cardiac surgery. The incidence was 47.2%. There were 158 strains of bacteria. Gram-negative bacteria accounted for 46.84%,followed by Gram-positive cocci （ 36.7% ） and fungi （16.46%）. The Logistic regression analysis of nosocomial infection revealed that duration of mechanical ventilation,length of stay in ICU,length of stay after operation were the related risk factors of nosocomial infection. The mortality rate of patients with nosocomial infection was 66.10%,and 49.94% in patients without nasocomial infection （χ^2=6.168,P=0.013）. CONCLUSIONS Having a high incidence of nosocomial infection,the mortality rate of patients with nosocomial infection is also high. The nosocomial infection is one of the risk factors of mortality after cardiac surgery who requiring CRRT. It is important to control the nosocomial infection.

关 键 词：心脏外科手术后 连续肾脏替代治疗 医院感染 

分 类 号：R181.32[医药卫生—流行病学]