血液透析患者血管通路感染  

Infections of vascular access in patients with hemodialysis

作　　者：蔡宗仰[1] 欧阳梓华[1] 禤伟振 容旭燕 彭莉[1] 萧浤 彭洪泉[1] 

机构地区：[1]澳门镜湖医院血液透析中心

出　　处：《肾脏病与透析肾移植杂志》2012年第2期145-147,182,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:探讨血液透析患者血管通路感染,了解其发生率和影响因素,为制订防治对策、降低感染的发生提供参考。方法:回顾性分析379例维持性血液透析患者的血管通路感染的情况。结果:自体动静脉内瘘者312例次,1例局部感染,移植血管瘘3例次,未见感染。长期导管感染率为0.836/1000导管日,颈静脉临时管感染率为1.759/1000导管日,而股静脉临时管感染率则为4.929/1000导管日。金黄色葡萄球菌(29.8%)是最常见致病菌,其次为白葡萄球菌(24.6%)、洋葱假单胞菌(10.1%)及大肠杆菌(5.3%)。结论:内瘘感染少见,而导管相关性感染具有特异性,洋葱假单胞菌可能易致隧道感染,拔除导管是治疗的主要措施,但应注意个体化防治。Objective： Vascular access for patients who require hemodialysis is a life-line, but infectious complications remain a major clinical problem. To discuss the incidence, risk factors of vascular access related infection in hemodialysis patients, and provide the preventive measures and Methodology： The vascular access infections among the total three hundred and seventy nine patients with maintenance hemodialysis were evaluated retrospectively in our dialysis unit. Results：The incidence of autogenous arteriovenous fistula is 1/312,and no infection among 3 cases with arteriovenous graft. The incidence of the long term catheter is 0. 836 episodes, jugular vein catheter is 1. 759 episodes and thigh vein catheter is 4. 929 episodes per 1 000 catheter days. As to the pathogenic bacteria, staphylococcus aureus was the most common pathogen, accounted for 29. 8 %, followed by staphylococcus albus （24. 6% ）, then pseudomonas cepacia （10. 05% ）, E. coli （5. 3% ）, and the other pathogens. Conclusion：The infection of fistula is very rare. Central venous catheter related infection is specific. Extubation is still the main measures to treat the infection, and the prevention and treatment should be individualized.

关 键 词：血液透析 导管相关性感染 致病菌 

分 类 号：R459.5[医药卫生—治疗学]