维持性血液透析患者感染的相关因素临床分析

目的分析维持性血液透析患者并发感染相关因素的临床特点。方法对近年来48例维持性血液透析患者临床资料进行回顾性分析,对感染性疾病、原发病因、营养状况、病原体进行总结。结果感染组28例患者共感染41次,感染性疾病依次为肺部感染(43.9%)、泌尿系感染(22%)和静脉导管相关性感染(9.7%);细菌培养15次,阳性6次,阳性率(40%);感染组中血红蛋白、血清白蛋白、每周透析时间显著低于非感染组(P<0.05),而患者的年龄和透龄明显高于非感染组。结论维持性血液透析患者感染率较高,原发病中尤以糖尿病及梗阻性肾病患者感染多见,透析不充分、贫血、低蛋白血症,内瘘引起肿胀手,中心静脉置管等侵袭性操作是并发感染的危险因素。

Objective To analyze the clinical feature of factors related to accompanying infection of patients with maintenance hemodialysis.Methods The clinical data of 48 patients with maintenance hemodialysis were retrospecteively analyzed.And the infectious diseases,original diseases,nutritional status and pathogens were summarized.Results 41 infection happened in 28 cases in infection group including lung（43.9%）,urinary（22%） and venous catheter-related infection（9.7%）.6 posotive results were found in 15 germicultures,posotive rate was 40%.Compared to non-infection group,hemoglobin,serum albumin and dialysis time each week was lower significantly（P0.05）,while the age of patients and dialysis was higher.Conclusion The infection rate was high in patients with maintenance hemodialysis.Infection usually happens in patients with diabetic and obstructive nephropathy.Insufficient dialysis,anaemia,hypoproteinemia,swollen hands by internal fistula and invasive operation such as central venous catheterization was the risk factor of accompanying infection.