维持性血液透析患者医院感染影响因素分析

Analysis of the influencing factors of nosocomial infection in patients with maintenance hemodialysis

目的观察维持性血液透析患者医院感染情况,并探寻影响因素,旨在为维持性血液透析患者医院感染的防治提供参考。方法回顾性分析连云港市第一人民医院血液透析净化中心2016年11月-2019年3月收治的105例患者的资料,所有入组患者均进行实验室相关检查及痰培养等,统计医院感染的情况,并将感染的患者纳入感染组共45例,其余患者纳入非感染组60例。调查患者一般人口学资料(年龄、性别、体质量指数、肾脏原发病、合并症等)与实验室相关检查(血清白蛋白、血红蛋白),归纳维持性血液透析患者医院感染的影响因素。结果入组患者中,合并糖尿病肾病55例、合并高血压肾病39例、慢性肾小球肾炎38例、狼疮肾炎与梗阻性肾病各3例,合并多囊肾、痛风性肾病、抗中性粒细胞胞浆抗体(Antineutrophil cytoplasmic antibody,ANCA)相关肾炎各2例,移植肾失功1例,其他10例,其中以合并糖尿病肾病、高血压性肾病、慢性肾小球肾炎较多,分别为52.38%、37.14%、36.19%;血红蛋白与血清蛋白、总胆固醇、合并糖尿病性肾病、高血压肾病是导致维持性血液透析患者医院感染的影响因素(P<0.05)。结论血红蛋白与血清蛋白偏低、合并糖尿病性肾病、高血压性肾病均可能增加维持性血液透析患者医院感染的发生风险,临床针对存在上述风险因素的患者应提高警惕,积极控制,以降低维持性血液透析患者发生医院感染的风险。

OBJECTIVE To observe the situation of nosocomial l infection in patients with maintenance hemodialysis and explore the influencing factors,so as to provide a reference for the prevention and treatment of nosocomial infection in patients with maintenance hemodialysis.METHODS The data of 105 patients who admitted to the hemodialysis purification center of Lianyungang first people’s hospital from Nov.2016 to Mar.2019 were retrospectively analyzed.All selected cases in the group were subjected to laboratory-related examinations and sputum culture.The number of nosocomial infections was counted,and a total of 45 patients with infection were included in infection group,and the remaining 60 patients were included in non-infection group.The general demographic data(age,gender,body mass index,renal primary diseases,complications,etc.)and laboratory-related examinations(serum albumin,hemoglobin)were investigated.The influencing factors of nosocomial infection in patients with maintenance hemodialysis were summarized.RESULTS Among the patients enrolled,there were 55 cases of diabetic nephropathy,39 cases of hypertensive nephropathy,38 cases of chronic glomerulonephritis,3 cases of lupus nephritis,3 cases of obstructive nephropathy,2 cases of polycystic kidney,2 cases of gout nephropathy,2 cases of Antineutrophil cytoplasmic antibody-related nephritis,1 case of renal allograft dysfunction and other 10 cases.Among them,there were more cases of diabetic nephropathy,hypertensive nephropathy,and chronic glomerulonephritis,which were 52.38%,37.14%,and 36.19%,respectively.Hemoglobin,serum protein,total cholesterol,combined diabetic nephropathy,and hypertensive nephropathy were the influencing factors for nosocomial infection in patients with maintenance hemodialysis(P<0.05).CONCLUSION Low hemoglobin and serum protein,combined diabetic nephropathy,and hypertensive nephropathy may increase the risk of nosocomial infections in patients with maintenance hemodialysis.Clinically,patients with above-mentioned risk factors should be vigilant and actively controlled to reduce the risk of nosocomial infection in patients with maintenance hemodialysis.