心脏死亡器官捐献肾移植术后受者泌尿系统感染发生率及经济负担分析  

Incidence and economic burden of urinary tract infection in donee after donation after cardiac death renal transplantation

作　　者：吕玉玲[1] 王丽丽[1] 杨吉伟[2] 宋珺瑶 门同义[2] 王建宁[2] 徐朋[1] LYU Yu-ling;WANG Li-li;YANG Ji-wei;SONG Jun-yao;MEN Tong-yi;WANG Jian-ning;XU Peng(The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Jinan,Shandong 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)感染管理科,山东济南250014 [2]山东第一医科大学第一附属医院(山东省千佛山医院)泌尿外科,山东济南250014 [3]山东第一医科大学第一附属医院(山东省千佛山医院)组织人事处,山东济南250014

出　　处：《中华医院感染学杂志》2020年第24期3766-3769,共4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(2018WS099)。

摘　　要：目的调查接受心脏死亡后器官捐献(DCD)供者供肾移植术后受者泌尿系统感染发生率及经济负担指标。方法收集2017年1月-2019年12月山东第一医科大学第一附属医院泌尿外科治疗的DCD供者供肾移植358例受者基本临床信息、感染情况和相关费用,采用流行病学病例对照研究方法,将肾移植术后发生泌尿系统感染的受者作为感染组,同期未发生泌尿系统感染(也未发生其他部位感染)的受者作为对照组。运用秩和检验比较感染组和对照组住院天数和住院费用,计算泌尿系统感染造成的经济负担。结果纳入的DCD供者供肾移植358例受者中,50例发生泌尿系统感染,感染发生率为13.97%。感染组受者住院费用中位数为154628.50元,对照组为112417.87元,两组比较差异有统计学意义(Z=-6.247,P<0.001),DCD供者供肾移植受者泌尿系统感染的直接经济负担为42210.63元;感染组住院天数中位数为29 d,对照组为24 d,两组比较差异有统计学意义(Z=-5.434,P<0.001),医院感染延长受者住院5 d;造成的间接经济负担为2037.60元,合计医院感染经济负担为44248.23元。结论DCD供者供肾移植术后泌尿系统感染后住院费用增加,住院时间延长,给受者造成巨大的经济负担。OBJECTIVE To investigate the incidence of urinary tract infection and economic burden in recipients of donation after cardiac death(DCD)renal transplantation,and to provide scientific basis for health administration to draft relevant policies.METHODS A retrospective survey of basic information,infectious status and related indicators of economic burden in patients received donation after cardiac death renal transplantation in the First Affiliated Hospital of Shandong First Medical University from Jan.2017 to Dec.2019.By using case-control study,50 recipients with urinary tract infection after renal transplantation were divided into the infection group,308 recipients without urinary tract infection and other site infection were in the control group.Hospitalization days and hospitalization expenses between the urinary tract infection group and control group were compared by Rank sum test,and the economic burden of nosocomial infection was calculated.RESULTS Urinary tract infection occurred in 50 of 358 DCD renal transplant recipients,with an infection rate of 13.97%.The median hospitalization expenses in the recipients of the infection group was$154628.50,and that in the control group was$112417.87.The difference between the two groups was significant(Z=-6.247,P<0.001).The direct economic burden of urinary tract infection on DCD kidney transplant recipients was$42210.63.The median length of hospitalization day in the infected group was 29 d,wheras that in the control group was 24 d.The difference between the two groups was significant(Z=-5.434,P<0.005).Nosocomial infection prolonged the hospitalization length in recipients for 5 days,resulting in an indirect economic burden of$2037.60 and total economic burden of$44248.23.CONCLUSION The length of hospitalization is prolonged and the cost of hospitalization in urinary tract infection after DCD kidney transplantation increases,which causes great economic burden to patients.

关 键 词：心脏死亡后器官捐献 肾移植 泌尿系统感染 经济负担 

分 类 号：R691.3[医药卫生—泌尿科学]