ICU连续性肾脏替代疗法治疗患者预防医院感染的管理措施

Study on preventive measures of nosocomial infections in patients with continuous renal replacement therapy in ICU

目的分析医院重症监护病房(ICU)行连续性肾脏替代疗法治疗(CRRT)患者医院感染的危险因素,为医院感染的管理及预防措施提供理论依据。方法回顾性分析医院ICU 2010年12月-2012年12月196例行CRRT的患者临床资料,统计分析患者医院感染的危险因素。结果 ICU行CRRT的196例患者中共发生医院感染34例,医院感染率为17.3%;单因素χ2检验显示,年龄>30岁,住院时间>7d,静脉置管时间>3d的CRRT患者具有较高的医院感染率(P<0.05);感染组中侵入性操作为(4.14±1.62)次,显著高于非感染组的(2.62±1.01)次,差异有统计学意义(P<0.05)。结论年龄、住院时间、静脉置管时间和侵入性操作是医院ICU行CRRT患者医院感染的主要影响因素,积极采取相应的预防措施有利于其医院感染发生率的降低。

OBJECTIVE To investigate the risk factors of nosocomial infections in patients with continuous renal replacement therapy（CRRT）in ICU so as to provide theoretical basis for the prevention and control of nosocomial infections.METHODS The medical records of 196cases of patients who underwent the CRRT in the ICU from Dec 2010to Dec 2012were retrospectively analyzed,then the risk factors for the nosocomial infections were statistically analyzed.RESULTS Of the 196cases of patients who underwent the CRRT in the ICU,the nosocomial infections occurred in 34cases with the incidence rate of 17.3%.The univariate chi-square test indicated that more than 30years of age,hospitalization duration more than 7days,and intravenous catheterization duration more than 3 days were the risk factors for nosocomial infections in the CRRT patients.The invasive operation was taken for（4.14±1.62）times in the infection group,significantly more than（2.62±1.01）times of the non-infection group（P0.05）.CONCLUSIONThe age,length of hospital stay,intravenous catheter indwelling,and invasive operation are the main risk factors for nosocomial infections in the CRRT patients,and the incidence of nosocomial infections can be reduced through corresponding prevention measures.