摘要
目的了解2019年度承德市中心医院行维持性血液透析(maintenance hemodialysis,MHD)患者继发感染情况,探讨MHD患者继发感染的相关影响因素。方法采用问卷调查法,对2019年1月至2019年12月在承德市中心医院血液透析室行MHD的158例患者进行年度持续追踪调查,用调查表登记MHD患者基本信息、感染发生情况及相关影响因素,对采集的数据进行统计学分析。结果对145例MHD患者进行了持续有效调查,其中发生继发感染患者81人,占55.86%。发生感染105例次,感染平均发生率0.73次/患者年。其感染部位发生情况依次为:呼吸道感染占47.62%、消化道感染占23.81%、泌尿道感染占14.29%、导管相关性感染占4.76%及皮肤感染占4.76%、糖尿病足继发感染占2.86%、其他感染占1.90%。MHD继发感染患者原发病构成结果分析显示:糖尿病肾病占38.27%、慢性肾小球肾炎占32.10%、高血压肾病17.28%,其他占12.35%。多因素Logistic回归分析结果显示,年龄≥60岁、血清ALB<35 g/L、Hb<90 g/L及伴有糖尿病与MHD患者继发感染相关,且差异有统计学意义(P<0.05)。结论本中心MHD患者感染发生率较高,且感染的影响因素较多,需不断加强感染相关影响因素分析,明确危险因素,制定和遵从个体化的感控措施应是降低MHD患者感染率的关键。
Objective This paper aims to investigate the current situation of secondary infection of patients undergoing maintenance hemodialysis(MHD)in Chengde Central Hospital in 2019,and to explore the related influencing factors of secondary infection of MHD patients,so as to provide data support for formulating and following individualized hemodialysis sensory control measures.Methods From January 2019 to December 2019,an annual continuous follow-up survey was conducted on 158 MHD patients in the hemodialysis room of Chengde Central Hospital.The basic information,infection situation and related influencing factors of MHD patients were registered with questionnaires,and the collected data were statistically analyzed.Results 145 MHD patients were investigated continuously and effectively,among which 81 patients had secondary infection,accounting for 55.86%.There were 105 cases of infection,and the average incidence of infection was 0.73 times per patient year.The infection sites were respiratory tract infection(47.62%),digestive tract infection(23.81%),urinary tract infection(14.29%),catheter-related infection(4.76%),skin infection(4.76%),secondary infection of diabetic foot(2.86%)and other infections(1.90%).The analysis of primary disease composition of MHD secondary infection patients showed that diabetic nephropathy accounted for 38.27%,chronic glomerulonephritis accounted for 32.10%,hypertensive nephropathy accounted for 17.28%,and others accounted for 12.35%.Multivariate Logistic regression analysis showed that age≥60 years old,serum ALB<35 g/L,Hb<90 g/L and diabetes were associated with secondary infection of MHD patients,and the difference was statistically significant(P<0.05).Conclusion The infection rate of MHD patients in our center is high,and there are many influencing factors of infection.It is necessary to continuously strengthen the analysis of influencing factors of infection and identify risks.Making and complying with individualized control measures should be the key to reduce the infection rate of MHD patients.
作者
何金红
陈建华
HE Jin-hong;CHEN Jian-hua(Chengde Medical College,Chengde Hebei 067000,China;Chengde Central Hospital,Second Clinical College of Chengde Medical College,Chengde Hebei 067000,China)
出处
《透析与人工器官》
2020年第4期26-29,共4页
Chinese Journal of Dialysis and Artificial Organs
关键词
终末期肾病
维持性血液透析
感染
影响因素
end-stage renal disease
maintenance hemodialysis(MHD)
infection
influencing factors
作者简介
何金红(1992-),女,硕士研究生。从事血液透析研究;通信作者:陈建华,E-mail:chjhua2005@sina.com。
