尿毒症患者医院感染及危险因素分析

Analysis of Nosocomial Infection and Risk Factors in Patients with Uremia

目的探讨尿毒症维持性血液透析(MHD)患者发生医院感染的特点及其危险因素。方法对284例尿毒症MHD患者进行回顾性调查,依据是否发生医院感染分为感染组(76例)和未感染组(208例);计算尿毒症患者的院内感染率,采用Logistic回归模型筛选影响尿毒症MHD患者医院感染的危险因素,并使用ROC曲线评价预测模型。结果尿毒症MHD患者的医院感染率为26.8%(76/284),感染部位以呼吸道、泌尿道及消化道为主;影响尿毒症MHD患者医院感染的因素包括年龄(OR=2.643)、糖尿病肾病(OR=4.773)、基础疾病(OR=3.604)、血清白蛋白(OR=2.385)、透析不充分(OR=4.323)及住院时间(OR=2.875)。结论尿毒症MHD患者具有较高的院内感染率,所建立的模型效果较好;应针对感染特点及高危因素行早预防,降低患者的医院感染率。

Objective To investigate the characteristics and risk factors of nosocomial infection in patients with uremic maintenance hemodialysis(MHD).Methods A retrospective survey of 284 patients with uremia MHD was conducted.According to whether nosocomial infection occurred,they were divided into an infected group(76 cases)and an uninfected group(208 cases).The nosocomial infection rate of uremia patients was calculated,and the logistic regression model was used to screen the risk factors of nosocomial infection in uremia MHD patients,and ROC was used to evaluate the prediction model.Results The nosocomial infection rate of uremia MHD patients was 26.8%(76/284),and the main infection sites were the respiratory tract,urinary tract and digestive tract.The factors affecting nosocomial infection of uremia MHD patients included age(OR=2.643),diabetic nephropathy(OR=4.773),underlying disease(OR=3.604),serum albumin(OR=2.385),inadequate dialysis(OR=4.323)and length of hospital stay(OR=2.875).Conclusion Patients with uremia MHD have a higher rate of nosocomial infection,and the established model has a better effect.Early prevention should be carried out according to the characteristics of infection and high-risk factors to reduce the rate of nosocomial infection of patients.