透析患者临时性中心静脉导管相关性血流感染危险因素分析  

Analysis of Risk Factors for Temporary Central Venous Catheter-related Bloodstream Infection in Dialysis Patients

作　　者：王奇娟 王少亭[1] 胡晓舟[1] 张瑾[1] 卢永申[1] 张燕[1] WANG Qi-juan;WANG Shao-ting;HU Xiao-zhou;ZHANG Jin;LU Yong-shen;ZHANG Yan(Department of Nephrology,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province,450052 China)

机构地区：[1]郑州大学第五附属医院肾内科,河南郑州450052

出　　处：《系统医学》2018年第19期13-15,共3页Systems Medicine

摘　　要：目的探讨血液透析患者临时性中心静脉导管相关性血流感染的危险因素,为降低感染率提供理论依据。方法统计2015年1月—2017年12月该院收治的484例临时性血液透析患者的临床资料,分析其性别、年龄、是否合并糖尿病、置管部位、导管留置时间、原发病及慢性肾脏患者相关检验指标与发生导管相关性血流感染的关系。结果 484例患者发生导管相关性血流感染29例(5.99%),其中年龄≤60岁感染率14.45%,高于>60岁的1.29%(χ~2=34.203,P=0.000);合并糖尿病感染率8.52%,高于未患糖尿病的3.83%(χ~2=4.694,P=0.030);导管留置时间>2周感染率14.74%,高于≤2周的1.83%(χ~2=31.302,P=0.000);原发病两两比较中,慢性肾功能不全感染率(9.05%)与急性肾损伤(0.69%)对比差异有统计学意义(χ~2=11.314,P=0.001),肾病综合征患者感染率(16.28%)与急性肾损伤(0.69%)及其他原发病(1.33%)对比差异有统计学意义(χ~2=15.717、7.093,P=0.000、0.008)。结论年龄≤60岁、合并糖尿病、导管留置时间>2周、原发病为肾病综合征或慢性肾功能不全是血液透析患者临时性中心静脉导管血流感染的危险因素。Objective To investigate the risk factors of temporary central venous catheter-related bloodstream infection in hemodialysis patients, and to provide a theoretical basis for reducing infection rate. Methods The clinical data of 484 patients with temporary hemodialysis admitted to the hospital from January 2015 to December 2017 were analyzed. The gender, age, diabetes, catheter placement, catheter indwelling time, primary disease and chronic kidney were analyzed. The relationship between patient-related test indicators and catheter-related bloodstream infections. Results Of the 484 patients, 29 cases（5.99%） had duct-related bloodstream infection, of which the infection rate was 14.45% at age ≤60 years old, which was higher than 1.29% at 〉60 years old （χ^2=34.203, P=0.000）. The rate was 8.52%, which was higher than 3.83% without diabetes （χ2=4.694, P=0.030）. The catheter indwelling time〉2 weeks infection rate was 14.74%, which was higher than 1.83% of ≤2 weeks （χ^2=31.302, P=0.000）; In the primary disease pairwise comparison, the rate of chronic renal insufficiency （9.05%） was statistically significant compared with acute kidney injury（0.69%） （χ^2=11.314, P=0.001）, infection in patients with nephrotic syndrome rate （16.28%） was statistically significant compared with acute kidney injury （0.69%） and other primary diseases （1.33%） （χ^2=15.717,7.093, P=0.000,0.008）. Conclusion Age ≤60 years, with diabetes, catheter indwelling time 〉2 weeks, primary disease, nephrotic syndrome or chronic renal insufficiency are not all the risk factors for temporary central venous catheter bloodstream infection in hemodialysis patients.

关 键 词：血液透析 导管相关性血流感染 危险因素 

分 类 号：R692[医药卫生—泌尿科学]