心血管置入式电子设备囊袋感染患者并发血流感染的危险因素  

Risk factors for concurrent bloodstream infection in patients with cardiovascular implantable electronic device pocket infection

作　　者：傅新镇 张玉榕[2] 张毅 贾荣波[3] 张宝凯[1] 杨金霞[4] FU Xin-zhen;ZHANG Yu-rong;ZHANG Yi;JIA Rong-bo;ZHANG Bao-kai;YANG Jin-xia(Bifizhou Peopleujulefinecls Hospitals Binzhou,Shandong 256610,China)

机构地区：[1]滨州市人民医院设备科,山东滨州256610 [2]滨州市人民医院医务科,山东滨州256610 [3]滨州市人民医院心内科,山东滨州256610 [4]滨州市人民医院感染科,山东滨州256610

出　　处：《中华医院感染学杂志》2020年第14期2174-2178,共5页Chinese Journal of Nosocomiology

基　　金：山东省医药卫生科技发展计划基金资助项目(2017ws375)。

摘　　要：目的分析心血管置入式电子设备(CIED)囊袋感染患者并发血流感染的危险因素。方法分析2014年6月-2019年6月因CIED囊袋感染入滨州市人民医院治疗的48例患者,根据患者是否合并血流感染,分为血流感染组和非血流感染组。通过单因素和多因素分析确定CIED囊袋感染患者并发血流感染的危险因素。结果48例患者中,其中34例合并血流感染,余14例未合并血流感染。两组患者的临床症状(症状持续>14 d、寒颤、全身不适及精神状态改变)、铅或电池侵蚀、生命体征、感染性休克、器官衰竭、白细胞计数、肌酐及谷草转氨酶水平差异具有统计学意义(P<0.05)。单因素的分析结果显示CIED囊袋感染患者并发血流感染的危险因素包括全身炎症反应(SIRS)、低血压、实验室检查结果异常>2项及症状持续>14 d。多因素的分析结果显示SIRS及低血压是CIED囊袋感染患者并发血流感染的危险因素。结论 SIRS及低血压是CIED囊袋感染患者并发血流感染的独立危险因素,早期诊断和治疗,可能有助于改善患者的预后。OBJECTIVE To analyze the risk factors for concurrent bloodstream infection in the patients with cardiovascular implantable electronic device(CIED)pocket infection.METHODS A total of 48 patients with CIED pocket infection who were treated in Binzhou People’s Hospital from Jun 2014 to Jun 2019 were enrolled in the study and divided into the bloodstream infection group and the non-bloodstream infection group.Univariate analysis and multivariate analysis were performed for the risk factors for the concurrent bloodstream infection in the patients with CIED pocket infection.RESULTS Among the 48 patients,34 were complicated with bloodstream infection,and 14 were not complicated with bloodstream infection.There were significant differences in the clinical symptoms(symptoms persisting for more than 14 days,chills,general malaise,and change of mental state),lead or battery erosion,vital signs,septic shock,organ failure,white blood cell count,creatinine,and aspartate aminotransferase between the two groups of patients(P<0.05).The result of univariate analysis showed that the risk factors for the concurrent bloodstream infection in the patients with CIED pocket infection included systemic inflammatory response syndrome(SIRS),hypotension,more than 2 items of abnormal laboratory test and symptoms persisting for more than 13 days.The result of multivariate analysis indicated that SIRS and hypotension were the risk factors for the concurrent bloodstream infection in the patients with CIED pocket infection.CONCLUSION SIRS and hypotension are the independent risk factors for the concurrent bloodstream infection in the patients with CIED pocket infection.Early diagnosis and treatment may facilitate the improvement of prognosis of the patients.

关 键 词：心血管置入式电子设备 囊袋感染 血流感染 危险因素 

分 类 号：R472[医药卫生—护理学]