慢性肾功能衰竭患者血液透析发生院内感染的临床分析

摘要

目的 分析慢性肾功能衰竭患者血液透析发生院内感染的临床特点以及相关危险因素.方法 回顾性分析2005年5月至2010年5月期间在我院长期行血液透析的383例患者的相关临床资料,将其中160例患者出现了不同程度的院内感染设为感染组,223例患者未出现院内感染为未感染组.结果 血液透析患者发生院内感染的发生率为41.78%,其中以肺部感染最为常见;感染组与未感染组患者之间的相关临床指标相比较,年龄、住院天数、是否左心衰、是否有糖尿病、是否存在低蛋白血症、插管时间以及C反应蛋白具有统计学差异(P<0.05或0.01),而性别、血肌酐、甘油三脂不具有统计学差异(P>0.05).结论 对于长期血液透析患者,我们应该控制好各个危险因素,规范化管理防治院内感染的相关制度,对患者采取正规的营养支持、纠正贫血、抗感染等支持治疗,及时的作相关病原学检查,严防滥用抗生素.%Objective To analyze the risk factors and clinical characteristics of nosocomial infection in hemodialysis for hospitalized patients with chronic renal failure. Methods The clinical data of 383 patients who underwent hemodialysis in our hospital from May 2005 to May 2010 were retrospectively analyzed including 160 infected patients and 223 uninfected patients. Results The incidence of nosocomial infection was 41.78 ％, with pulmonary infection being the most common type. There were statistical differences in age, hospital duration,intubation time, C-reactive protein and whether with left heart failure, diabetes and hypoalbuminemia (P ＜ 0.05 or P ＜ 0.01 ) between the two groups. But no statistical difference was found in gender, creatinine and triglycerides( P ＞ 0.05 ). Conclusion Measures should be taken to control the risk factors, standardize the regulations related to the prevention of nosocomial infection and provide correct nutritional support for patients with chronic nosocomial infection in hemodialysis. Meanwhile, timely etiology check is necessary to avoid the overuse of antibiotics