1781例血液净化患者导管相关性感染情况及影响因素分析  

Catheter-related infection and its influencing factors in 1781 patients with blood purification

作　　者：唐晓娟[1] 刘小兰[1] 张敏[1] TANG Xiao-juan;LIU Xiao-lan;ZHANG Min(West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《华南预防医学》2022年第3期311-314,共4页South China Journal of Preventive Medicine

摘　　要：目的研究血液净化患者导管相关性感染情况及影响因素,为防治及减少血液净化患者导管相关性感染的发生提供参考。方法将2018年1月至2021年6月成都某医院肾内科进行血液净化治疗的1781例患者作为研究对象,观察患者导管相关性感染发生情况,对可能引发感染的因素进行单、多因素分析。结果1781例血液净化患者中,男性942例,女性839例;年龄37~76岁,平均(65.9±5.6)岁。317例血液净化患者发生导管相关性感染,感染发生率为17.80%,感染类别依次为隧道感染95例(29.97%)、导管定植89例(28.08%)、出口感染70例(22.08%)、血行感染63例(19.87%)。年龄、合并糖尿病、合并低蛋白血症、穿刺次数、留置导管时间、住院时间、应用抗菌药情况不同的血液净化患者导管相关性感染发生率差异均有统计学意义(均P<0.01)。多因素Logistic回归分析显示年龄(OR=1.706)、合并糖尿病(OR=2.077)、合并低蛋白血症(OR=1.960)、穿刺次数≥2次(OR=1.283)、留置导管时间≥1周(OR=2.588)、住院时间≥2周(OR=1.387)、应用抗菌药(OR=0.352)是血液净化患者导管相关性感染发生的影响因素。结论血液净化患者导管相关性感染率较高,与年龄、合并糖尿病、合并低蛋白血症、穿刺次数、留置导管时间、住院时间、应用抗菌药有关。Objective To study the situation and influencing factors of catheter-related infection in patients with blood purification,so as to provide reference for the prevention and reduction of catheter-related infection in patients with blood purification.Methods A total of 1781 patients receiving blood purification in the Department of Nephrology,West China Hospital,Sichuan University from January 2018 to June 2021 were selected as the research objects,the occurrence of catheter-related infection in patients was observed,univariate and multivariate analysis methods were performed on the factors that may lead to infection.Results Among 1781 patients with blood purification,942 were male and 839 were female.The age ranged from 37 to 76 years,with average of(65.9±5.6)years.Catheter-related infection occurred in 317 cases,and the incidence rate was 17.80%.The constituent ratio of infection causes from high to low was tunnel infection(95 cases,29.97%),catheter colonization(89 cases,28.08%),export infection(70 cases,22.08%),and bloodstream infection(63 cases,19.87%).There were statistically significant differences in the incidence of catheter-related infection among patients with different ages,whether with diabetes mellitus,whether with hypoproteinemia,puncture times,indwelling catheter time,hospitalization time and application of antibiotics(all P<0.01).Multivariate Logistic regression analysis showed that age(OR=1.706),diabetes mellitus(OR=2.077),hypoproteinemia(OR=1.960),puncture times≥2(OR=1.283),indwelling catheter time≥1 week(OR=2.588),hospitalization time≥2 weeks(OR=1.387)and application of antibiotics(OR=0.352)were the influencing factors of catheter-related infection in patients with blood purification.Conclusion The rate of catheter-related infection in patients with blood purification is high,which is related to age,diabetes mellitus,hypoproteinemia,puncture times,indwelling catheter time,hospitalization time and application of antibiotics.

关 键 词：血液净化 导管相关性感染 影响因素 

分 类 号：R194.2[医药卫生—卫生事业管理]