尿毒症维持性血液透析患者院内感染的相关影响因素及护理措施分析

Analysis of related influencing factors and nursing measures of nosocomial infection in uremic maintenance hemodialysis patients

目的分析尿毒症维持性血液透析(MHD)患者院内感染相关影响因素及护理措施,为临床防控感染提供依据。方法回顾性分析2020年5月-2022年5月南昌大学第二附属医院收治的行MHD的尿毒症患者78例的临床资料,统计院内感染发生情况。整理患者临床资料,具体包括性别、年龄、体质量指数(BMI)、有无合并糖尿病肾病等,分析影响尿毒症MHD患者发生院内感染的相关因素。结果78例尿毒症MHD患者中,共15例患者发生院内感染,院内感染率为19.23%,其中呼吸道感染6例,泌尿系统感染5例,透析导管感染2例,皮肤及软组织感染2例;单因素分析显示,性别、文化水平与尿毒症MHD患者发生院内感染无关,无统计学差异(P>0.05);年龄、BMI、糖尿病肾病、血红蛋白、血清白蛋白、导管留置时间与尿毒症MHD患者发生院内感染有关,有统计学差异(P<0.05);Logistic回归分析显示:年龄>60岁、BMI<18kg/m2、有糖尿病肾病、血红蛋白<110g/L、血清白蛋白<35g/L、导管留置时间>4d是尿毒症MHD患者发生院内感染高危因素(P<0.05)。结论尿毒症MHD患者感染部位多见于呼吸道、泌尿系统,且院内感染的发生与年龄、BMI、糖尿病肾病、血红蛋白、血清白蛋白、导管留置时间密切相关,临床应以此为依据采取相关护理措施,以增强医院感染防控效果。

Objective To analyze the related influencing factors and nursing measures of nosocomial infection in uremic maintenance hemodialysis(MHD)patients,and to provide basis for clinical prevention and control of infection.Methods The clinical data of 78 uremic patients with MHD admitted to our hospital from May 2020 to May 2022 were analyzed retrospectively.The clinical data of patients were sorted out,including gender,age,body mass index(BMI),presence or absence of diabetic nephropathy,and the related factors affecting hospital infection in uremic MHD patients were analyzed.Results Among 78 patients with uremic MHD,15 patients had hospital infection,the hospital infection rate was 19.23%,including 6 cases of respiratory tract infection,5 cases of urinary system infection,2 cases of dialysis catheter infection,and 2 cases of skin and soft tissue infection;univariate analysis showed that there was no significant difference between gender,education level and hospital infection in uremic MHD patients(P>0.05);age,BMI,diabetic nephropathy,hemoglobin,serum albumin,catheter indwelling time were related to hospital infection in uremic MHD patients,with statistical differences(P<0.05);Logistic regression analysis showed that age>60,BMI<18kg/m2,diabetic nephropathy,hemoglobin<110g/L,serum albumin<35g/L,catheter retention time>4d were the high risk factors for hospital infection in uremic MHD patients(P<0.05).Conclusion The infection sites of uremic MHD patients are mostly found in the respiratory tract and urinary system,and the occurrence of hospital infection is closely related to age,BMI,diabetic nephropathy,hemoglobin,serum albumin,and catheter retention time.Clinical nursing measures should be taken on this basis to enhance the effectiveness of hospital infection prevention and control.