维持性血液透析患者医院感染相关危险因素分析

Analysis of Risk Factors Related to Nosocomial Infection in Maintenance Hemodialysis Patients

目的分析维持性血液透析(MHD)患者发生医院感染的相关危险因素。方法回顾性分析2013年1月—2017年12月该院MHD患者的临床资料123例,分析其医院感染部位、原发疾病及易感因素。结果 123例MHD患者发生感染65例,医院感染率52.8%;最常见的感染部位为呼吸道(35/65,53.85%),主要原发疾病为糖尿病肾病(40/65,61.5%),感染组中合并糖尿病、长期卧床、合并低蛋白血症,住院时间>30 d、透析龄>1年、Hb≤90 g/L,与非感染组比较,差异有统计学意义(χ~2=5.556,P=0.018;χ~2=4.264,P=0.039;t=3.288,P=0.001;χ~2=19.949,P=0.000;χ~2=4.855,P=0.028;χ~2=5.024,P=0.025)。结论合并糖尿病、Hb≤90 g/L、低蛋白血症、住院时间>30 d、透析龄>1年等是MHD患者发生医院感染的高危因素。

Objective To analyze the risk factors associated with nosocomial infection in patients with maintenance hemodialysis (MHD). Methods A retrospective analysis of 123 patients with MHD in the hospital from January 2013 to December 2017 was conducted to analyze the location of the hospital infection, the primary disease and the predisposing factors. Results There were 65 cases of infection in 123 cases of MHD. The hospital infection rate was 52.8%. The most common infection site was respiratory tract (35/65, 53.85%). The main primary disease was diabetic nephropathy (40/65, 61.5%). In the infected group, diabetes, long-term bed rest, and hypoproteinemia, hospitalization time>30 days, dialysis age>1 year, Hb≤90 g/L.The difference was statistically significant compared with the non-infected group(χ^2=5.556, P=0.018;χ^2=4.264, P=0.039; t=3.288, P=0.001;χ^2=19.949, P=0.000;χ^2=4.855, P=0.028;χ^2=5.024, P=0.025). Conclusion Diabetes mellitus, Hb≤90 g/L, hypoproteinemia, hospitalization time >30 days, and dialysis age >1 year are risk factors for nosocomial infection in MHD patients.