尿毒症血液透析患者医院感染危险因素分析

Risk factors for nosocomial infections in uremia patients undergoing hemodialysis

目的探讨尿毒症血液透析患者医院感染的发生及引起感染的危险因素,旨在预防及降低尿毒症血液透析患者医院感染的发生。方法回顾性分析208例尿毒症维持性血液透析患者的临床资料,分析尿毒症血液透析患者医院感染的危险因素。结果 208例患者发生医院感染63例、101例次,医院感染率30.29%、例次感染率48.56%,其中多重感染23例;感染部位以呼吸道为主,占52.48%,其次为泌尿道、透析导管、胃肠道、皮肤及软组织感染;患者的年龄、体质量指数、糖尿病肾病、住院时间、血清白蛋白、血红蛋白、C-反应蛋白与患者发生医院感染有关(P<0.05),多因素logistic回归分析结果显示,患者年龄、体质量指数、糖尿病肾病、住院时间、血清白蛋白、血红蛋白是引起患者发生医院感染的独立危险因素(P<0.05)。结论引起尿毒症血液透析患者发生医院感染的危险因素较多,应针对危险因素进行干预以降低医院感染的发生。

OBJECTIVE To investigate the occurrence of nosocomial infections in patients with uremia hemodiaiysis and risk factors of infections so as to reduce the incidence Of nosocomial infections in the uremia patients undergo- ing hemodialysis. METHODS The clinical data from 208 cases of uremia patients with maintenance hemodialysis were retrospectively analyzed, and the risk factors of nosocomial infectioE for uremia patients with hemodialysis were analyzed. RESULTS Among 208 cases of patients, 68 cases were with hospital infection in 101 cases times, and hospital infection rate was 30.29%, the case-time infection rate was 48.56%, among which 23 patients were with multiple infections; the infection site was mainly in respiratory tract, accounting for 52.48 %, followed by u rinary tract, dialysis catheter, gastrointestinal tract, skin and soft tissue. Patient＇s age, body mass index, diabetic nephropathy, hospttalization duration, serum albumin, hemoglobin, c-reactive protein had relation to nosocomial infection （P〈0.05）, the multi-factor Logistic regression analysis results showed that patients＇ age, body mass in- dex, diabetic nephropathy, hospitalization duration, serum albumin, hemoglobin were the independent risk factors of nosocomial infection （P〈0.05）. CONCLUSION There are many risk factors for the nosocomial infections in the uremia patients undergoing hemodialysis, and the interventions should be taken by aiming at the risk factors so as to reduce the incidence of nosocomial infections.