摘要
目的 探讨尿毒症血液透析患者导管相关性感染(CRI)现状、风险因素.方法 纳入2020年1月至2023年6月东南大学附属中大医院287例尿毒症患者,收集一般资料、临床资料及病原菌分布情况,分析尿毒症血液透析患者发生CRI的风险因素.结果 287例尿毒症血液透析患者CRI发生率为18.47％(53/287),病原菌中革兰氏阳性菌占62.92％.两组年龄、住院时间、合并糖尿病、导管留置时间及白蛋白(Alb)、尿素氮、血肌酐、C反应蛋白、白细胞计数及血红蛋白(Hb)水平比较,差异有统计学意义(P＜0.05).年龄＞60岁、住院时间≥4 d、合并糖尿病、导管留置时间≥2周、Alb≤35 g/L、Hb≤110 g/L为尿毒症血液透析患者发生CRI的风险因素(OR＞1,P＜0.05).结论 年龄＞60岁、住院时间≥4 d、合并糖尿病、导管留置时间≥2周、Alb≤35 g/L、Hb≤ 110 g/L是尿毒症血液透析患者发生CRI的风险因素,临床可据此进行针对性预防,并参照主要致病菌进行对应抗菌治疗,以改善尿毒症血液透析患者预后.
Abstract
Objective To explore the current situation and risk factors of catheter-related infection(CRI)in uremic hemodialysis patients.Methods A total of 287 patients with uremia in Zhongda Hospital,Southeast University from January 2020 to June 2023 were included.General data,clinical data,and pathogenic bacteria distribution were collected,and the risk factors of CRI in uremic hemodialysis patients were analyzed.Results The incidence of CRI in 287 uremic hemodialysis patients was 18.47％(53/287).Gram positive bacteria accounted for 62.92％of the pathogenic bacteria.There were significant differences in age,hospital stay,diabetes mellitus,catheter retention time and the levels of albumin(Alb),blood urea nitrogen,serum creatinine,C-reactive protein,white blood cell count,and hemoglobin(Hb)between two groups(P＜0.05).Age＞60 years old,hospital stay ≥4 d,diabetes mellitus,catheter retention time≥2 weeks,Alb ≤35 g/L,and Hb ≤110 g/L were risk factors for CRI in uremic hemodialysis patients(OR＞1,P＜0.05).Conclusion Age＞60 years old,hospital stay≥4 d,diabetes mellitus,catheter retention time≥2 weeks,Alb ≤35 g/L,and Hb ≤ 110 g/L were risk factors for CRI in uremic hemodialysis patients.Targeted prevention can be carried out according to these risk factors,and corresponding antibacterial treatment can be carried out according to the main pathogenic bacteria to improve the prognosis of uremic hemodialysis patients.
基金项目
江苏省医院协会医院管理创新研究项目(JSYGY-3-2023-412)
维普
万方数据