血液透析深静脉置管导管相关性感染的临床特点及感染因素分析

Study of clinical characteristics and infection factors of catheter-associated infection with deep vein catheterization in hemodialysis

目的分析血液透析深静脉置管导管相关性感染(CRI)的临床特点及感染因素。方法选取医院2020年1月至2023年6月收治的血液透析深静脉置管患者470例进行回顾性分析。根据患者临床资料进行感染情况统计与分组,分为感染组与非感染组,对引发感染可能相关因素进行分析。结果470例患者中23例发生CRI,感染率为4.89%;共计检出病原菌22株,其中革兰氏阳性菌13株,革兰氏阴性菌9株。经单因素分析,年龄、合并糖尿病、插管位置、置管时间、导管类型、透析时间、穿刺次数、白蛋白水平是患者发生CRI的因素(P<0.05);经多因素Logistic回归分析,年龄、合并糖尿病、置管时间、导管类型、透析时间、白蛋白水平是发生感染的危险因素(P<0.05)。结论血液透析深静脉置管患者发生CRI的概率较高,引发感染的危险因素多,临床应根据患者实际情况进行置管情况的评估,针对影响因素进行防治措施地个性化制定,以使感染率降低,提升置管安全。

Objective To analyze the clinical characteristics and infectious factors of catheter-associated infection(CRI)in hemodialysis.Methods 470 hemodialysis patients with deep vein catheterization admitted to the hospital from January 2020 to June 2023 were retrospectively analyzed.Infection statistics and pathogens were recorded according to the clinical data of the patients.The patients were divided into infected group and non-infected group according to whether infection occurred.Univariate and Logistic regression analysis was performed on the possible factors related to infection.Results CRI occurred in 23 of 470 patients,the infection rate was 4.89%.A total of 22 pathogenic strains were detected,including 13 Gram-positive strains and 9 Gram-negative strains.By univariate analysis,age,diabetes mellitus,intubation location,catheter time,catheter type,dialysis time,puncture times and albumin level were the factors of CRI occurrence(P<0.05).Multivariate Logistic regression analysis showed that age,diabetes mellitus,catheter time,catheter type,dialysis time and albumin level were the risk factors for infection(P<0.05).Conclusion Patients with deep vein catheterization of hemodialysis have a higher incidence of CRI,and there are many risk factors causing infection.Clinical evaluation of catheterization should be conducted according to the actual situation of patients,and prevention and treatment measures should be personalized according to the influencing factors,so as to reduce the infection rate and improve the safety of catheterization.