CRRT患者医院获得性肺炎的特点及相关因素的临床分析

Clinical analysis of characteristics and related factors of hospital-acquired pneumonia in CRRT patients

目的 分析连续性肾脏替代治疗(continuous renal replacement therapy, CRRT)患者医院获得性肺炎的特点及相关影响因素。方法 回顾性分析常熟市第一人民医院2015年—2021年共580例CRRT患者的临床资料。CRRT肺炎患者73例作为观察组,未出现肺炎的CRRT患者507例为对照组。从医院电子数据库获取患者人口学资料、临床信息及检验指标。通过logistic回归分析CRRT患者医院获得性肺炎的相关因素。结果 CRRT患者医院获得性肺炎发病率为12.6%,主要病原菌为金黄色葡萄球菌(58.57%)。logistic回归分析显示:年龄≥65岁、意识障碍、初治时间≥72 h、器官衰竭≥3个、基础疾病≥3个、APACHE II评分和CCI评分是CRRT患者医院获得性肺炎的危险因素(P<0.05),血清白细胞计数、白蛋白和血红蛋白水平是保护因素(P<0.05)。结论 通过改变危险因素,如提供足够的营养,早期治疗基础疾病,控制器官衰竭,可以降低CRRT患者医院获得性肺炎的患病风险。

Objective To analyze the characteristics and related influencing factors of nosocomial pneumonia in patients with continuous renal replacement therapy(CRRT). Methods The clinical data of 580 CRRT patients admited to Changshu the First People’s Hospital the from 2015 to 2021 were retrospectively analyzed. 73 CRRT patients with pneumonia served as the observation group, and 507 CRRT patients without pneumonia served as the control group. Obtain patient demographic data, clinical information and test indicators from the hospital electronic database. logistic regression was used to analyze the related factors of hospital-acquired pneumonia in CRRT patients. Results The incidence of nosocomial pneumonia in CRRT patients was 12.6%, and the main pathogen was Staphylococcus aureus(58.57%). logistic regression analysis showed that: age≥65 years, impaired consciousness, initial treatment time≥72 h, organ failure ≥3, underlying disease≥3, APACHE II score and CCI score were risk factors for hospital-acquired pneumonia in CRRT patients(P<0.05). Serum white blood cell count, albumin and hemoglobin levels were protective factors(P<0.05). Conclusion By changing the risk factors, such as providing adequate nutrition, early treatment of underlying diseases, and control of organ failure, the risk of nosocomial pneumonia in CRRT patients can be reduced.