血液透析患者医院感染的危险因素分析

Analysis of risk factors causing nosocomial infections to hemodialysis patients

目的分析血液透析患者发生医院感染的危险因素,探讨其护理要点,以期为临床防治提供相关依据。方法回顾性分析医院2009年3月-2013年2月241例血液透析患者的临床资料,对其发生医院感染的危险因素进行分析,并结合临床经验提供针对性地护理措施,采用SPSS17.0软件进行统计分析。结果 241例血液透析患者发生医院感染57例,感染率为23.65%;感染部位以呼吸系统和消化道为主,分别占42.11%和31.58%;年龄≥60岁、住院时间≥30d、有留置导管及原发病为糖尿病肾病是血液透析患者发生医院感染的危险因素,其医院感染率分别为34.48%、28.81%、29.56%、35.38%,差异有统计学意义(P<0.05);经非条件logistic多元回归分析显示,患者年龄大、住院时间长、留置导管、原发病为糖尿病肾病是血液透析患者医院感染的独立危险因素(均P<0.05)。结论改善血液透析患者营养、采用全身支持疗法、尽量缩短住院天数、做好医院消毒工作、采取有效地护理措施,对减少血液透析患者医院感染具有重要作用。

OBJECTIVE To analyze the risk factors causing nosocomial infections to hemodialysis patients and to discuss nursing points so as to provide relevant evidence for clinical prevention and treatment .METHODS The clinical data of 241 cases of hemodialysis patients from March 2009 to Feb 2013 were retrospectively investigated , the risk factors causing nosocomial infections to them were analyzed ,and they were given corresponding nursing measures combined with clinical experience ;SPSS 17 .0 software was adopted for statistical analysis .RESULTS Totally ,57 of 241 cases of hemodialysis patients suffered nosocomial infections ,with infection rate of 23 .65% . The dominant infection sites were respiratory system and digestive tract ,accounting for 42 .11% and 31 .58%respectively .The infection rates for patients at 60 years old or above ,patients had hospital stay for 30 days or longer ,patients with indwelling catheter ,and patients with diabetic nephropathy as primary illness were 34 .48% , 28 .81% ,29 .56% ,and 35 .38% ;there was significant difference（P〈 0 .05）;all of these factors were the risk factors causing nosocomial infections ;unconditioned logistic regression analysis showed that old age ,long hospital stay , indwelling catheter and primary illness of diabetic nephropathy were independent risk factors causing nosocomial infections to hemodialysis patients .CONCLUSIONS It is of great importance to reduce the incidence of nosocomial infections for the hemodialysis patients through improving nutrition of patients , taking systemic supportive therapy ,shortening hospital stay ,and perfectly performing disinfection and taking effective nursing measures .