透析频率对维持性血液透析患者感染的影响研究

Influence of frequency of dialysis on incidence of infections in maintenance hemodialysis patients

目的研究探讨不同透析频率对维持性血液透析患者并发感染的影响,为临床调整合理的透析方案,降低患者并发感染提供临床依据。方法选择2010年1月-2012年4月医院收治的维持性血液透析患者64例为研究对象,按就诊号随机分为A、B、C组,A组患者19例透析频率为3次/周,B组患者25例透析频率为2次/周,C组患者20例透析频率为3次/2周,观察记录患者感染情况及病死率,全部数据均应用SPSS17.0软件统计分析。结果 A、B、C组患者感染率分别为42.11%、52.00%、75.00%;C组患者的感染率显著高于A组(χ2=4.358,P<0.05);A、B、C组患者感染部位均以肺部感染为主,分别占53.85%、68.42、36.84%;64例患者的病死率为15.63%,A、B、C组分别为35.00%、8.00%、5.26%。结论随着透析频率的减小患者的感染率、病死率呈上升趋势,适当的增加透析频率,能够有效预防感染的发生,提高患者生存率。

OBJECTIVE To explore the impact of different frequencies of dialysis on the incidence of infections in the maintenance hemodialysis patients so as to propose reasonable dialysis program and reduce the incidence of compli- cated infections. METHODS A total of 64 patients who underwent the maintenance hemodialysis in the hospital from Jan 2010 to Apt 2012 were enrolled in the study and divided into the group A, B, and C according to the treatment number, then the 19 cases in the group A received the dialysis with the frequency of 3 times a week, the 35 cases in the group B received the dialysis with the frequency of 2 times a week, and the 20 cases in the group C received the dialysis with the frequency of three times per two weeks; the incidence of infections and the mortality of the patients were observed and recorded, and all the data were statistically analyzed with the use of SPSS17.0 software. RESULTS The incidence of infections was 42.11% in the group A, 52.00% in the group B, 75.00% in the group C; the incidence of infections of the group C was significantly higher than that of the group A（x2 = 4. 358, P〈0.05）. The patients with pulmonary infections were dominant in all the three groups, the patients with pulmonary infections accounted for 53.85% in the groups A, 68.42 in the group B, 36.84% in the group C. A- mong the 64 patients, the mortality rate was 15.63%, 35.00% in the group A, 8.00% in the group B, 5.26% in the group C. CONCLUSION With the decrease of frequency of dialysis, the incidence of infections shows an upward trend, and the mortality rate is increased as well. Appropriate increase of dialysis frequency may effectively prevent the infections and improve the survival rate of the patients.