2018—2023年某三甲医院心脏移植术后感染情况及相关危险因素分析

Analysis of infection and related risk factors after heart transplantation in a third-grade class-A hospital from 2018 to 2023

目的 调查2018—2023年某三甲医院心脏移植(HT)术后感染情况,并探讨其危险因素。方法 回顾性分析2018年1月—2023年7月行HT术的314例患者的临床资料,根据术后感染情况将其分为感染组和对照组,记录患者一般信息,对HT术后感染的可能影响因素进行单因素分析,并通过多因素Logistic回归分析筛查HT术后感染的危险因素。结果 91例(28.98%)患者术后发生感染,主要感染部位为呼吸道、血液。Logistic回归分析显示,HT术后感染发生的危险因素主要包括合并慢性肺部疾病、手术时间≥5 h、术后胸腔引流管留置时间长、术后尿管留置时间长、术后机械通气时间长、术前白蛋白(Alb)<35 g/L。结论 合并慢性肺部疾病、手术时间≥5 h、术后胸腔引流管留置时间长、术后尿管留置时间长、术后机械通气时间长、术前Alb<35 g/L与HT术后感染发生有关,故应对患者上述因素进行积极干预,以降低感染风险。

Objective To investigate the infection status after heart transplantation(HT)in a third-grade class-A hospital from 2018 to 2023,and explore its risk factors.Methods A retrospective analysis was conducted on the data of 314 patients who underwent HT surgery from January 2018 to July 2023,they were divided into infection group and control group according to postoperative infection situation,the possible influencing factors of HT postoperative infection were analyzed by univariate analysis,and the risk factors of HT postoperative infection were screened by multivariate Logistic regression analysis.Results A total of 91 patients(28.98%)developed postoperative infections,with infection sites of respiratory tract and blood.Logistic regression analysis showed that the main risk factors for postoperative infection in HT patients included complicating with chronic lung disease,surgical time≥5 h,long retention time of postoperative thoracic drainage tube,long postoperative urinary tube retention time,long postoperative mechanical ventilation time,and preoperative Alb<35 g/L.Conclusion Complicating chronic lung disease,surgical time≥5 h,long postoperative thoracic drainage tube retention time,long postoperative urinary tube retention time,long postoperative mechanical ventilation time,preoperative Alb<35 g/L are related to postoperative infection of HT.Therefore,active intervention should be carried out for the above factors in patients to reduce the risk of infection.