血液透析患者医院感染危险因素分析及预防对策  

Risk factors for nosocomial infections in hemodialysis patients and prevention countermeasures

作　　者：胡玉纹[1] 陈学波[1] 张亮[1] 吴广宇[1] 林诗彬[2] 

机构地区：[1]舟山市人民医院血液净化中心,浙江舟山316004 [2]海南医学院附属医院超声科,海南海口570102

出　　处：《中华医院感染学杂志》2014年第1期128-129,135,共3页Chinese Journal of Nosocomiology

基　　金：舟山市医药卫生青年科技人才专项科研基金(2009B14)

摘　　要：目的探讨血液透析患者医院感染的危险因素,并制定相关的预防策略,降低感染的发生。方法对医院2010年3月-2011年3月120例血液透析患者的临床资料进行回顾性分析,探究其发生医院感染的危险因素。结果 120例血液透析患者中有65例发生医院感染,感染率为54.2%;其中,感染部位主要为呼吸系统、泌尿系统、消化系统、循环系统、血管通路及其他,分别占30.8%、24.5%、18.5%、12.3%、7.7%、6.2%;年龄>60岁、住院时间>20d、血液透析时间>1年、伴有糖尿病、血红蛋白<60g/L、血白蛋白<30g/L和伴有心力衰竭以及伴有静脉插管等均是影响感染的危险因素。结论血液透析患者发生医院感染的危险因素较多,临床中应加强对患者基础疾病的治疗,增强其机体的免疫力,规范整个操作过程,避免交叉感染,提高整体的预防效果。OBJECTIVE To explore the risk factors for nosocomial infections in hemodialysis patients and put forward corresponding prevention strategies so as to reduce the incidence of infections.METHODS The clinical data of 120 patients who underwent the hemodialysis in the hospital from Mar 2010 to Mar 2011were retrospectively analyzed,and the risk factors for the nosocomial infections were observed.RESULTS Of totally 120 cases of hemodialysis patients,the nosocomial infections occurred in 65cases with the infection rate of 54.2%,among which the patients with respiratory tract infections accounted for 30.8%,the patients with urinary tract infections 24.5%, the patients with gastrointestinal tract infections 18.5%,the patients with circulatory system infections 12.3%, the patients with blood vessel infections 7.7%,others 6.2%.The more than 60years of age,hospitalization duration more than 20days,hemodialysis time more than one year,complication of diabetes,hemoglobin level less than 60g/L,serum albumin level less than 30g/L,complication of heart failure,and venous cannula were the risk factors for the nosocomial infections.CONCLUSIONThere are a variety of risk factors for the nosocomial infections in the hemodialysis patients;it is necessary for the hospital to strengthen the treatment of underlying diseases,enhance the immunity,and standardize the whole operation procedure so as to avoid cross infections and improve integrated prevention effect.

关 键 词：血液透析 医院感染 危险因素 预防对策 

分 类 号：R181.32[医药卫生—流行病学]