慢性肾衰竭血液透析患者合并医院感染危险因素分析及其对预后的影响

The analysis on the risk factors and influences on prognosis of nosocomial infection in CRF patients undergoing hemodialysis

目的探讨慢性肾衰竭(CRF)血液透析患者合并医院感染危险因素分析及其对预后的影响。方法回顾性分析2019年1月至2020年1月我院收治的80例CRF血液透析患者的临床资料,根据疾病转归情况将患者分为感染组(n=31)和非感染组(n=49),分析影响CRF血液透析患者医院感染的危险因素及其对预后的影响。结果单因素分析显示,年龄、合并糖尿病、合并心力衰竭、血红蛋白、C反应蛋白、住院时间、中心静脉置管是影响CRF血液透析患者感染的因素(P<0.05),性别、使用激素、透析龄、血肌酐、尿酸盐、胱抑素、三酰甘油、血钙、血磷水平对CRF血液透析患者医院感染的影响较小(P>0.05)。多因素分析显示:合并糖尿病、中心静脉置管、血红蛋白<70 g/L、住院时间≥30 d是影响CRF血液透析患者医院感染的独立危险因素(P<0.05,OR>1)。感染组患者6个月生存率为74.19%(23/31)低于非感染组6个月生存率91.84%(45/49),差异有统计学意义(P<0.05)。结论合并糖尿病、中心静脉置管、血红蛋白<70 g/L、住院时间≥30 d与CRF血液透析患者合并医院感染相关,从生存情况来看,非感染者的预后情况优于感染者。

Objective To explore the risk factors of nosocomial infection in patients with chronic renal failure(CRF)undergoing hemodialysis(HD)and its influences on the prognosis.Methods The clinical data of 80 CRF patients who underwent HD and were admitted to the hospital from January 2019 to January 2020 were retrospectively analyzed.According to disease outcomes,they were divided into infection group(n=31)and non-infection group(n=49).The risk factors of nosocomial infection in CRF patients undergoing HD and its influences on prognosis were analyzed.Results Univariate analysis showed that age,diabetes,heart failure,hemoglobin,C-reactive protein,hospitalization time and central venous catheteriation were influencing factors of infection in CRF patients undergoing HD(P<0.05).The effects of gender,glucocorticoids usage,dialysis age,serum creatinine,urate,cystatin,triglyceride,serum calcium and serum phosphorus were few on nosocomial infection(P>0.05).Multivariate analysis showed that diabetes,central venous catheteriation,hemoglobin lower than 70g/L and hospitalization time not shorter than 30d were independent risk factors influencing nosocomial infection(P<0.05,OR>1).The six-month survival rate in infection group was lower than that in non-infection group[74.19%(23/31)vs.91.84%(45/49),P<0.05].Conclusion Diabetes,central venous catheteriation,hemoglobin lower than 70 g/L and hospitalization time more than 30 d are related to nosocomial infection in CRF patients undergoing HD.In terms of survival status,prognosis of non-infection patients is better than that of infection patients.