维持性血液透析患者感染的临床特点及其相关因素分析

Infection Episode and Related Risk Factors in Continuous Hemodialysis Patients: A Survey

目的了解维持性血液透析患者感染的临床特点及相关因素。方法对近年来180例次维持性血液透析患者住院的临床资料进行回顾性分析,对感染部位、病原体、原发病因及营养状况进行总结。结果感染组86例次患者共感染113例次,感染部位依次为肺部(36.9%)、泌尿系(21.6%)和静脉导管(11.8%);进行细菌培养50例次,阳性38例次,病原学以革兰阴性杆菌(占60.3%)常见;感染组中血红蛋白、血清白蛋白显著低于非感染组(P<0.05),而患者的年龄和自费比率却明显高于非感染组;血液透析患者乙型肝炎病毒携带率为18.3%、丙型肝炎病毒阳性率为8.7%。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SLE患者感染多见,血液透析患者乙型肝炎病毒携带率和丙型肝炎病毒阳性率均较高。

OBJECTIVE To investigate the infection episode and related risk factors in continuous hemodialysis patients. METHODS The relationship among infection and etiologies of infection, nutritional status, pathogens and causes of chronic renal failure （CRF） were retrospectively analyzed in 180 continuous hemodialysis patients. RESULTS Totally 113 times infections were observed among the 86 inpatients under continuous hemodialysis. The main infectious site in hemodialysia patients was lungs. Thirty eight times were positive in 50 times of etiologic detection, Gram-negative germ was the most common （60. 3 %）. Hemoglobin and serum albumin decreased obviously in infectious patients. Diabetes and systemic lupus erythematosus patients were more susceptible to infection. The hepatitis virus infections rate in hemodialysis patients was relatively high. CONCLUSIONS There is higher infections rate in continuous hemodialysis patients. Diabetes and systemic lupus erythematosus patients are more susceptible to infection. Anemia, lower serum albumin, old age and bad compliance are the susceptible factors.