不同透析频率对维持性血液透析患者感染的影响

Influence of different dialysis frequence on infection of maintenance hemodialysis patients

目的研究不同透析频率对维持性血液透析患者感染、转归的影响。方法根据透析频率将53例慢性肾衰竭维持性血液透析患者分为三组：A组19例，每周透析3次；B组15例，每周透析2次；C组19例，每2周透析3次。记录透析1年内三组感染发生情况及死亡例数。结果三组共发生感染62例次，A组17例次，B组18例次，C组27例次；感染部位依次为肺部35例次（56．45％）、血管通路14例次（22．58％）、尿路8例次（12．90％）和消化道5例次（8．06％）。三组共死亡8例，病死率15．09％（8/53）。A组死亡1例，B组死亡1例，C组死亡6例。三组预后比较差异有统计学意义（χ2=6．293，P〈0．05）。结论透析频率低于2次／周的患者感染发生率高，病死率也高。应调整透析方案，增加透析频率。

Objective To study the influence of different dialysis frequence on infection and prognosis of maintenance hemodialysis patients. Methods Fifty-three maintenance hemodialysis patients with chronic kidney disease were divided into 3 groups. Groups A, B, C dialysed thrice per week（ 19 cases ）, twice per week （ 15 cases） and thrice per two weeks （ 19 cases）, respectively. All the patients were dialysed for 1 year. The rate of infection, death number and death reason were recorded. Results All the cases were infected 62 times （ 17 times in group A, 18 times in group B and 27 times in group C）. Pulmonary infection, blood vessels infection, urinary tract infection and digestive tract infection happened 35 times（56.45% ）, 14 times （22.58%）, 8 times （12.90%） and 5 times （8.06%） respectively. Eight eases died in three groups, and the total death rate was 15.09% , with 1 case in group A,1 case in group B and 6 cases in group C. There was significant difference in prognosis among three groups （χ2 = 6.293,P 〈 0.05）. Conclusions Patients who dialysis less than twice per week have higher rate of infection and death. Dialysis program should be adjusted and dialysis frequence should be increased.