首页|肾病血液透析合并肺部感染的影响因素分析及病原菌特点

肾病血液透析合并肺部感染的影响因素分析及病原菌特点

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目的:探讨肾病血液透析合并肺部感染的影响因素,并分析病原菌分布特点.方法:选取2022 年 1 月—2023 年 9 月宜春市人民医院收治的 128 例肾病血液透析患者作为研究对象,根据是否发生肺部感染将患者分为阳性组(肺部感染)和阴性组(无肺部感染),所有患者均行血液透析治疗,统计患者肺部感染率,分析病原菌分布特点,收集患者的一般临床资料进行单因素分析,并进一步分析肺部感染的影响因素.结果:128 例患者中,30 例患者发生肺部感染,发生率为 23.44%.共分离出 46 株病原菌,革兰阴性菌 30 株(65.22%),其中肺炎克雷伯菌占比最高(45.65%);革兰阳性菌 16 株(34.78%),其中金黄色葡萄球菌占比最高(21.74%).阳性组年龄大于阴性组,透析时间、住院时间均长于阴性组,血红蛋白、血清白蛋白水平均低于阴性组,空腹血糖、营养不良占比、肾功能(失代偿期)占比均高于阴性组(P<0.05);多因素logistic回归分析显示,年龄、透析时间、住院时间、血红蛋白、血清白蛋白、空腹血糖、营养不良、肾功能均为肾病血液透析合并肺部感染的影响因素(P<0.05).结论:年龄、透析时间、住院时长、血红蛋白、血清白蛋白、空腹血糖、营养状况、肾功能是肾病血液透析患者并发肺部感染的影响因素,其感染的病原菌主要为肺炎克雷伯菌与金黄色葡萄球菌.
Analysis of Influencing Factors and Characteristics of Pathogenic Bacteria of Nephrosis with Hemodialysis Complicated with Pulmonary Infection
Objective:To explore the influencing factors of nephrosis with hemodialysis complicated with pulmonary infection,and to analyze the distribution characteristics of pathogenic bacteria.Method:A total of 128 nephrosis with hemodialysis patients admitted to Yichun People's Hospital from January 2022 to September 2023 were selected as the study objects,and the patients were divided into a positive group(pulmonary infection)and a negative group(no pulmonary infection)according to whether pulmonary infection occurred or not.All patients were treated with hemodialysis,the pulmonary infection rate of patients was counted,and the distribution characteristics of pathogenic bacteria were analyzed.The general clinical data of the patients were collected for single factor analysis,and the influencing factors of pulmonary infection were further analyzed.Result:Among 128 patients,30 patients developed pulmonary infection,with an incidence rate of 23.44%.A total of 46 strains of pathogenic bacteria were isolated,of which 30 were Gram negative bacterium(65.22%),and Klebsiella pneumoniae(45.65%)accounted for the highest proportion.There were 16 Gram positive bacteria(34.78%),among which Staphylococcus aureus(21.74%)accounted for the highest proportion.The age of positive group was older than that of negative group,the dialysis time and hospital stay were longer than those of negative group,the levels of hemoglobin and serum albumin were lower than those of negative group,and fasting blood glucose,the proportion of malnutrition and renal function(decompensation stage)were higher than those of negative group(P<0.05).Multivariate logistic regression analysis showed that age,dialysis time,hospital stay,hemoglobin,serum albumin,fasting blood glucose,malnutrition and renal function were all influencing factors of nephrosis with hemodialysis complicated with pulmonary infection(P<0.05).Conclusion:Age,dialysis time,hospital stay,hemoglobin,serum albumin,fasting blood glucose,malnutrition and renal function are the factors affecting pulmonary infection in patients with nephrosis with hemodialysis.The main pathogens of infection are Klebsiella pneumoniae and Staphylococcus aureus.

NephrosisHemodialysisPulmonary infectionInfluencing factorsCharacteristics of pathogenic bacteria

雷萌、吴雯、邬俊勇、徐石张

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宜春市人民医院检验科 江西 宜春 336000

宜春市人民医院肾内科 江西 宜春 336000

肾病 血液透析 肺部感染 影响因素 病原菌特点

宜春市指导性科技计划(2023)

2023ZDJH2721

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(15)
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