老年慢性肾衰竭维持性血液透析患者医院感染相关因素分析  

Related risk factors for nosocomial infections in elderly patients with chronic renal failure undergoing maintenance hemodialysis

作　　者：叶白如[1] 谷禾[1] 杨午红[1] 金领微[1] 黄蔷薇[1] 

机构地区：[1]温州医科大学附属第二医院血液净化中心,浙江温州325000

出　　处：《中华医院感染学杂志》2015年第10期2247-2249,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(Y2090522)

摘　　要：目的探讨老年慢性肾衰竭维持性血液透析患者发生医院感染部位分布及相关危险因素,为降低医院感染率提供依据。方法回顾性分析2011年1月-2014年12月120例老年慢性肾衰竭维持性血液透析患者临床资料,分析其感染部位及相关危险因素,采用SPSS18.0软件进行统计分析。结果 120例老年慢性肾衰竭维持性血液透析患者发生医院感染42例,感染率为35.0%,感染部位以导管感染为主,占30.95%,其次为呼吸道、消化道、泌尿系统,分别占26.19%、23.81%、9.52%;老年慢性肾衰竭维持性血液透析患者发生医院感染后均给予抗感染治疗,疗程(13.6±4.2)d,统计各感染部位抗感染治疗时间及住院时间,各组比较差异无统计学意义;多因素logistic回归分析显示,住院时间、伴有糖尿病、血红蛋白、血白蛋白、中心静脉置管等因素是发生医院感染的独立危险因素。结论老年慢性肾衰竭维持性血液透析患者发生医院感染相关危险因素较多,临床应采取针对性干预措施,加强血液透析室医务人员感染管理及规范操作,加强治疗老年患者基础疾病,以降低血液透析室患者医院感染率。OBJECTIVE To explore the related risk factors for nosocomial infections in elderly patients with chronic renal failure patients undergoing maintenance hemodialysis and observe the nosocomial infection sites so as to re‐duce the incidence of nosocomial infections .METHODS A total of 120 elderly patients with chronic renal failure who underwent the maintenance hemodialysis from Jan 2011 to Dec 2014 were enrolled in the study ,then the clini‐cal data of the participants were retrospectively analyzed ,the infection sites and related risk factors for the infec‐tions were observed ,and the statistical analysis was performed with the use of SPSS18 .0 software .RESULTS The nosocomial infections occurred in 42 of 120 elderly patients with chronic renal failure undergoing maintenance he‐modialysis ,with the infection rate of 35 .0% .Of the patients with nosocomial infections ,30 .95% had the cathe‐ter‐related infections ,26 .19% had the respiratory tract infections ,23 .81% had the gastrointestinal tract infec‐tions ,and 9 .52% had the urinary tract infections .The anti‐infection treatment was conducted for the elderly pa‐tients with chronic renal failure undergoing maintenance hemodialysis ,with the mean treatment course of （13 .6 ± 4 .2） day .There was no significant difference in the time of treatment of the nosocomial infections or the length of hospital stay .The multivariate logistic regression analysis indicated that the length of hospital stay ,complication of diabetic mellitus ,hemoglobin ,albumin ,and central venous catheter indwelling were the independent risk fac‐tors for the nosocomial infections .CONCLUSION There are a variety of risk factors for the nosocomial infections in the elderly patients with chronic renal failure undergoing maintenance hemodialysis .It is necessary for the health care workers of the hemodialysis room to take targeted interventions ,strengthen the control of infections and standard operation ,and enhance the treatment of underling diseases in the elderly patie

关 键 词：老年患者 慢性肾衰竭 维持性血液透析 医院感染 

分 类 号：R181.32[医药卫生—流行病学]