应用涤纶环中心静脉留置导管血液透析患者医院感染临床分析  

Clinical analysis of nosocomial infections in patients undergoing hemodialysis by central venous catheter with polyester ring

作　　者：张磊[1] 王志奎[1] 周忠启[1] 任岳钦[1] 

机构地区：[1]临沂市人民医院肾内科,山东临沂276000

出　　处：《中华医院感染学杂志》2015年第15期3488-3489,3503,共3页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅科技基金资助项目(SW-2010B-019)

摘　　要：目的调查分析血液透析应用带涤纶环中心静脉留置导管患者医院感染情况,以降低医院感染率。方法选取2011年1月-2013年12月于医院应用带涤纶环中心静脉留置导管进行血液透析患者247例,分别取导管端及采集患者的血液进行病原菌培养,分析其感染率、病原菌类型及分布,采用SPSS 13.0进行统计分析。结果 247例行血液透析的患者,发生医院感染18例,感染率7.29%,患有糖尿病肾病、慢性肾炎、高血压肾病及其他肾病患者发生医院感染率分别为8.99%、4.10%、10.64%以及5.26%;共检出18株病原菌,以革兰阳性菌为主,共10株占55.55%,其次为革兰阴性菌,共7株占38.90%,真菌1株,占5.55%。结论应用带涤纶环中心静脉留置导管进行血液透析,医院感染率低、安全性高、留置时间长,为中心静脉留置导管提供了一种可行的通路,值得临床应用。OBJECTIVE To analyze nosocomial infections in patients undergoing hemodialysis by central venous catheter with polyester ring ,in order to reduce nosocomial infection rates .METHODS Totally 247 patients under‐going hemodialysis by central venous catheter with polyester ring during Jan .2011 - Dec .2013 were enrolled and blood samples were taken from the catheter end and from the patients for pathogen culture .The nosocomial infec‐tion rate and the types and distribution of pathogens were analyzed .The software SPSS13 .0 was used for statisti‐cal analysis .RESULTS Among 247 patients undergoing hemodialysis ,18 had nosocomial infections ,the incidence rate was 7 .29% .Among them ,the nosocomial infection rates of patients with diabetic nephropathy ,chronic glo‐merulonephritis ,hypertensive nephropathy and other kidney diseases were 8 .99% ,4 .10% ,10 .64% and 5 .26% . Totally 18 pathogenic strains were detected ,mainly including gram‐positive bacteria （10 ,55 .55% ） ,followed by gram‐negative bacteria （7 ,38 .90% ） and fungi （1 ,5 .55% ） .CONCLUSION Hemodialysis by central venous cath‐eter with polyester ring demonstrates low incidence of nosocomial infections ,high safety and long retention time , polyester ring provides a feasible path for central venous catheterization and is worthy of clinical application .

关 键 词：血液透析 中心静脉留置导管 医院感染 

分 类 号：R181.32[医药卫生—流行病学]