维持血液透析患者中心静脉导管相关血流感染影响因素及其交互作用研究  

Study on the Influencing Factors of Central Venous Catheter-related Bloodstream Infections and Their Interaction in Maintenance Hemodialy⁃sis Patients

作　　者：梁勋枢 李金梅[1] 江春锦 陆凤明 LIANG Xunshu;LI Jinmei;JIANG Chunjin;LU Fengming(Department of Nephrology,Guigang Pingnan County People's Hospital,Guigang,Guangxi Zhuang Autonomous Region,537300 China)

机构地区：[1]广西贵港市平南县人民医院肾内科,广西贵港537300

出　　处：《系统医学》2024年第5期98-101,共4页Systems Medicine

摘　　要：目的探索维持血液透析患者中心静脉导管相关血流感染影响因素及其交互作用。方法回顾性选取2019年9月—2022年9月贵港市平南县人民医院行维持血液透析的299例患者的临床资料,按照是否感染分感染组(25例),未感染组(274例),通过多因素Logistic回归分析中心静脉导管相关性血流感染(Catheter Related Blood Stream Infection,CRBSI)的影响因素,并进一步探讨因素间的交互作用。结果多因素Logistic回归分析结果显示,年龄≥60岁、置管时间≥14 d、置管位置在股静脉、白蛋白(Albumin,ALB)<30 g/L是CRBSI发生的危险因素(OR=1.369、11.339、4.847、1.273,P均<0.05)。交互作用分析中,ALB<30 g/L与置管位置在股静脉存在相乘交互作用(P<0.05),不存在相加交互作用[超额相对危险度(Relative Excess Risk of Interaction,RERI)、归因比(Attributable Proportion of,AP)的95%CI包含0,交互作用指数(Synergy Index,S)的95%CI包含1]。结论维持血液透析患者CRBSI的影响因素为患者年龄、置留部位、置留时间、ALB。ALB<30 g/L与置管位置在股静脉之间存在相乘交互作用。Objective To explore the influencing factors of central venous catheter-related bloodstream infections and their interaction in maintenance hemodialysis patients.Methods The clinical data of 299 patients undergoing hemodi⁃alysis in Pingnan County People's Hospital of Guigang City from September 2019 to September 2022 were retrospec⁃tively selected.According to whether they were infected,they were divided into infected group(25 cases)and unin⁃fected group(274 cases).Multivariate Logistic regression was used to analyze the influencing factors of central cath⁃eter related blood stream infection(CRBSI)and to further explore the interactions among these factors.Results Multi⁃variate Logistic regression analysis showed that age≥60 years old,catheter placement time≥14 days,catheter place⁃ment in femoral vein and albumin(ALB)<30 g/L were risk factors for CRBSI(OR=1.369,11.339,4.847,1.273,all P<0.05).In the interaction analysis,there was a multiplicative interaction between ALB<30 g/L and catheter placement location in the femoral vein(P<0.05),with no additive Interaction[95%CI of relative excess risk of interaction(RERI),and attributable proportion(AP)contains 0,95%CI of synergy index(S)contains 1].Conclusion The factors influenc⁃ing the maintenance of CRBSI in hemodialysis patients were patient age,placement site,placement time and ALB.There was a multiplicative interaction between ALB<30 g/L and catheter placement position in the femoral vein.

关 键 词：维持血液透析 中心静脉导管 血流感染 影响因素 交互作用 

分 类 号：R459.5[医药卫生—治疗学]