血液透析置管患者发生导管相关血行感染的影响因素分析

Analysis of the influencing factor of catheter-related bloodstream infection in patients with hemodialysis catheter

目的:探讨血液透析置管患者发生导管相关血行感染的影响因素。方法:选取肾病科住院并进行血液透析患者372例,根据患者是否发生导管相关血行感染分为感染组38例和对照组334例,收集患者的临床资料,对导管血行感染的相关因素进行分析。结果:372例血液透析置管患者中,导管相关血行感染的发生率为10.22%,置管感染的时间为(25.46±8.72)d。检出病原微生物共37株,其中革兰阳性菌28株占75.68%,革兰阴性菌7株占18.92%,真菌2株占5.40%。多因素logistic回归分析结果显示,合并糖尿病、贫血、营养不良、导管留置部位为股静脉、血清白蛋白<30 g/L是发生导管相关血行感染的危险因素。结论:针对导管相关血行感染的危险因素,应采取有针对性的防治措施,从而降低导管感染的发生率,提高血液透析患者的生存率。

Objective： To investigate the influencing factors of catheter-related bloodstream infection in patients with hemodialysis catheter. Methods： Three hundred and seventy-two patients with hemodialysis catheter in Department of Nephrology were divided into the infection group（ 38 cases） and control group（ 334 cases） according to the patients with catheter-related bloodstream infection. The clinical data of the patients were collected,and the catheter-related bloodstream infection factors were analyzed. Results： The incidence of catheter-related bloodstream infection and time of catheter infection in 372 patients were 10. 22% and（ 25. 46 ± 8. 72） d,respectively. Thirty-seven strains of pathogenic bacteria in catheter bloodstream infection were identified,which included 28 strains of Gram-positive bacteria（ 75. 68%）,7 strains of Gram-negative bacteria（ 18. 92%） and 2 strains of fungi（ 5. 40%）. Multivariate Logistic regression analysis showed that diabetes mellitus,anemia,malnutrition,catheter indwelling in femoral vein and serum albumin less than30 g / L were the risk factors of catheter bloodstream infection. Conclusions： Taking targeted measures against the risk factor of catheter bloodstream infection can reduce the incidence of catheter infection,and improve the survival rate of patients with hemodialysis.