血液透析患者医院感染的护理管理

Nursing management of nosocomial infection in hemodialysis patients

目的了解血液透析患者医院感染的分布及危险因素,以便采取相应的护理对策。方法回顾性分析146例血液透析患者的临床资料,对其年龄、基础疾病、插管方式、病原学及实验室检查结果与感染发生的相关性进行统计学分析。结果 146例血液透析患者发生医院感染43例,医院感染发生率29.5%;感染部位主要为导管相关感染、呼吸道、泌尿道感染,感染率分别为41.9%、27.9%、11.6%;原发病为糖尿病肾病、年龄>60岁,血白蛋白及血红蛋白水平越低感染发生率越高,差异均有统计学意义(P<0.05)。结论加强医务人员及陪护人员的培训,改善营养状况,加强血液透析的规范化管理,控制感染的危险因素,能有效预防和减少医院感染发生。

OBJECTIVE To understand the distribution and risk factors of nosocomial infection in hemodialysis patients,thus to take appropriate nursing measures.METHODS The clinical data of 146 cases of hemodialysis patients were respectively reviewed.The relationship between the occurrence of nosocomial infection and patients′ age,underlying diseases,intubation method,etiology and laboratory results were statistically analyzed.RESULTS There were 43 nosocomial infection cases from 146 cases,the infection rate was 29.5%.The main infection sites were catheter-related infections,respiratory tract and urinary tract,the infection rates were 41.9%,27.9% and 11.6%.Diabetic nephropathy as the primary diseases and aged over 60 years old were the risk factors for nosocomial infection,the lower the levels of albumin and hemoglobin,the higher the incidence rate of infection was,the differences were statistically significant（P0.05）.CONCLUSION Various measures,including strengthening the training for medical personnel and accompanying personnel,improving the nutritional status of the patients,enhancing standardized management of hemodialysis and the risk factors of infection,can effectively prevent and reduce the occurrence of nosocomial infection in hemodialysis patients.