重症监护室连续血液净化患者导管相关性感染的影响因素分析

Analysis of Influencing Factors of Catheter-related Infection in Patients with Continuous Blood Purification in Intensive Care Unit

目的探究在重症监护室(ICU)进行连续血液净化患者导管相关性感染的影响因素及预防措施。方法回顾性分析2020年5月至2022年5月于医院ICU行持续血液净化的82例患者的临床资料,根据导管相关性感染发生情况分为未发生组(62例)、发生组(20例)。收集两组临床资料,经单因素、多因素分析ICU连续血液净化患者发生导管相关性感染的影响因素。结果单因素分析表明,性别、原发疾病、置管部位与ICU连续血液净化患者导管相关性感染无关,差异无统计学意义(P>0.05);年龄、合并糖尿病、穿刺次数、合并低蛋白血症、导管留置时间、ICU住院时间、使用免疫抑制剂与导管相关性感染有关,差异有统计学意义(P<0.05);Logistic回归分析表明,年龄≥60岁、合并糖尿病、穿刺次数≥3次、导管留置时间≥10 d、合并低蛋白血症、ICU住院时间≥14 d、使用免疫抑制剂均为重症监护室连续血液净化患者发生导管相关性感染的高危因素(P<0.05)。结论年龄、穿刺次数、合并糖尿病、导管留置时间、合并低蛋白血症、ICU住院时间、使用免疫抑制剂均是影响ICU连续血液净化患者发生导管相关性感染的危险因素,临床需针对该类高危因素,采取有效护理措施,以降低感染发生风险。

Objective The influencing factors and preventive measures of catheter-associated infection in patients undergoing continuous blood purification in intensive care unit(ICU)were investigated.Methods With retrospective analysis of clinical data of 82 patients who underwent continuous blood purification in the ICU of the hospital from May 2020 to May 2022,the patients were divided into non-occurrence group(62 cases)and occurrence group(20 cases),according to the occurrence of catheter related infection.The clinical data of two groups were collected,and the influencing factors of catheter-related infection in patients with continuous blood purification in ICU were analyzed by single and multiple factors.Results Univariate analysis showed that sex,primary disease and catheter location were not related to catheter-related infection in patients with continuous blood purification in ICU,and the difference was not statistically significant(P>0.05);Age,diabetes,puncture times,hypoproteinemia,catheter retention time,ICU hospitalization time,use of immunosuppressants were related to catheter related infection,and the difference was statistically significant(P<0.05);Logistic regression analysis showed that age≥60 years old,diabetes mellitus,puncture times≥3 times,catheter retention time≥10 d,hypoproteinemia,ICU stay≥14d and use of immunosuppressive agents were all high risk factors for catheter-related infection in patients with continuous blood purification in ICU(P<0.05).Conclusions Age,puncture times,diabetes,catheter retention time, hypoproteinemia, ICU hospital stay, and use of immunosuppressants areall risk factors for catheter related infection in patients undergoing continuous blood purification inICU. In order to reduce the risk of infection, effective nursing measures should be taken for thesehigh-risk factors.