血液透析患者导管相关性血流感染的影响因素分析  

Influence factor analysis of catheter-related bloodstream infections in hemodialysis patients

作　　者：王文静[1] 张燕[1] 唐伟华[1] 

机构地区：[1]莱芜市人民医院血液透析室,山东莱芜271100

出　　处：《中华医院感染学杂志》2014年第16期4004-4005,4008,共3页Chinese Journal of Nosocomiology

基　　金：莱芜市卫生局科研基金项目[莱科鉴字(2007)90]

摘　　要：目的探讨血液透析患者导管相关性血流感染的影响因素并提出相应的处理措施,为临床资料提供参考依据。方法选取2011年1月-2013年3月医院收治血液透析患者240例,对其临床资料进行回顾分析,统计患者的基本资料和治疗情况,数据采用SPSS13.0软件进行分析。结果 240例血液透析患者共发生导管相关性血流感染37例,发生率15.42%;年龄>60岁、血红蛋白<100g/L、白蛋白<40g/L、插管次数≥3次以及合并糖尿病者均是血液透析患者容易发生导管相关性血流感染的危险因素;经过logistic回归分析,患者的年龄、血红蛋白和白蛋白水平、插管次数、导管留置时间以及是否合并糖尿病者均是血液透析患者发生导管相关性血流感染的独立危险因素。结论影响血液透析患者导管感染的因素多种多样,临床应以预防为主,一旦发生感染,应积极解除引起感染的原因,并通过局部涂抹抗菌药物、抗菌药物封管,局部消毒换药进行处理。OBJECTIVE To explore the influence factors for catheter-related bloodstream infections in hemodialysis patients and propose appropriate countermeasures for reference for clinical data.METHODS Totally 240 hemodialysis patients admitted in our hospital in Jan.2011 to Mar.2013 were selected and their clinical data were retrospectively analyzed,the general information of the patients and treatment conditions were statistically analyzed with SPSS 13.0.RESULTS There were 37 cases of catheter-related bloodstream infections in the 240 hemodialysis patients,with the occurrence rate of 15.42%.The risk factors for catheter-related infection were age60 years,hemoglobin100g/L,albumin40g/L,intubation≥3 times and complication with diabetes.logistic regression analysis showed the patient′s age,hemoglobin and albumin levels,the number of intubation,catheter retention time and complication with diabetes were independent risk factors for catheter-related bloodstream infection in hemodialysis patients.CONCLUSION The influence factors for catheter infection in hemodialysis patients are various.Clinical treatment should be focused on prevention,induces should be resolved in a positive manner and the patient should be treated by topical smear with antibiotics,tube sealing with antibiotics and local disinfection dressing once the infection occurs.

关 键 词：血液透析 导管 感染 

分 类 号：R181.32[医药卫生—流行病学]