维持性血液透析患者血管通路感染的调查与分析

Investigation and analysis of causes of vascular access infections in patients with maintenance hemodialysis

目的分析维持性血液透析患者血管通路感染的原因,为临床预防血管通路感染提供参考。方法选取2009年1月-2011年1月医院血液透析室进行透析的170例患者,将其分为对照组和试验组各85例;对照组采用长期留置插管法,试验组患者采用动静脉内漏,观察两组患者血管通路感染的发生率和病原菌。结果试验组发生血管通路感染率为29.41%,低于对照组的55.29%,差异有统计学意义(P<0.05);共分离出123株病原菌,其中革兰阳性菌30株占24.39%,革兰阴性菌80株占65.04%,真菌13株占10.57%;对照组分离出82株病原菌,试验组分离出41株;感染患者经有效治疗后痊愈。结论血管通路感染直接威胁血透患者的生命,为降低血管通路感染率,应正确认识及处理血管通路感染的危险因素,早期诊断并进行及时、合理的治疗。

OBJECTIVE To analyze the causes of vascular access infections in patients with maintenance hemodialysis and provide reference for the prevention of vascular access infections.METHODS A total of 170 patients undergoing hemodialysis from Jan 2009 to Jan 2011 were selected and divided into the control group（n=85） and the study group（n=85）;the control group was taken long-term indwelling catheterization method,and the study group was treated with direct arteriovenous leakage;the incidence of vascular access infections and the pathogens between the two groups were observed.RESULTS The rate of vascular access infections in the study group was lower than that of the control group（29.41% vs 55.29%,P〈0.05）;a total of 123 strains were isolated,including 30 strains of gram-positive bacteria（24.39%）,80 strains of gram-negative bacteria（65.04%）,and 13 strains of fungi（10.57%）;82 strains were isolated from the control group,41 strains from the study group;the patients with infections were cured after effective treatment.CONCLUSION The vascular access infections can directly threaten the lives of patients undergoing hemodialysis;to reduce the rate of infection of vascular access infections,we should understand and deal with risk factors for vascular access infections correctly,as well as the treatment and diagnosis in a timely and reasonable manner.