急性肾衰竭CRRT治疗患者并发导管相关性血流感染的危险因素分析

Risk factors for catheter related-blood stream infection in patients with acute kidney injury treated by CRRT

目的探讨急性肾衰竭连续性肾脏替代疗法(CRRT)治疗患者并发导管相关性血流感染(CRBSI)的危险因素。方法回顾性抽取2020年9月至2023年9月于河南省人民医院接受CRRT治疗的急性肾衰竭患者235例,依据是否并发CRBSI将其分为感染组(26例)和未感染组(209例)。收集患者临床资料,采用单因素和多因素Logistic回归分析探讨急性肾衰竭CRRT治疗患者并发CRBSI的危险因素。结果单因素分析显示,感染组年龄≥60岁、合并糖尿病、置管部位股静脉、留置导管时间>7 d者占比高于未感染组(P<0.05),白蛋白(ALB)水平低于未感染组(P<0.05)。多因素Logistic回归分析结果显示,年龄≥60岁、合并糖尿病、股静脉置管、留置导管时间>7 d为急性肾衰竭CRRT治疗患者并发CRBSI的危险因素(OR>1,P<0.05),ALB为急性肾衰竭CRRT治疗患者并发CRBSI的保护因素(OR<1,P<0.05)。结论急性肾衰竭CRRT治疗患者并发CRBSI的风险较高,年龄≥60岁、合并糖尿病、股静脉置管、留置导管时间>7 d为患者并发CRBSI的危险因素,ALB为患者并发CRBSI的保护因素。

Objective To investigate the risk factors for catheter-related blood stream infection(CRBSI)in patients with acute kidney injury treated by continuous renal replacement therapy(CRRT).Methods A total of 235 patients with acute kidney injury who received CRRT treatment in Henan Provincial People’s Hospital from September 2020 to September 2023 were retrospectively selected,and they were divided into an infection group(26 cases)and a non-infection group(209 cases)according to occurrence of CRBSI.The clinical data of the selected patients were collected.Univariate and multivariate logistic regression analyses were used to analyze the risk factors for CRBSI in patients with acute kidney injury treated by CRRT.Results Univariate analysis showed that the proportion of patients aged≥60 years,diabetes mellitus,catheterization in femoral vein,and indwelling catheter time>7 days in the infection group were higher than those in the non-infection group(P<0.05),while the albumin(ALB)level in the infection group was lower than that in the non-infection group(P<0.05).The results of multivariate logistic regression analysis showed that age≥60 years,diabetes mellitus,catheterization in femoral vein,and indwelling catheter time>7 days were risk factors for CRBSI in patients with acute kidney injury treated by CRRT(OR>1,P<0.05).ALB was a protective factor for CRBSI in patients with kidney injury treated by CRRT(OR<1,P<0.05).Conclusions Patients with acute kidney injury treated by CRRT have a high risk of CRBSI;age≥60 years,diabetes mellitus,catheterization in femoral vein,and indwelling catheter time>7 days are risk factors for CRBSI,while ALB is a protective factor for CRBSI.