| 何亚京,马平悦,应素奇,杨丽莉,杨秀,费晓,王鸣.血液透析患者导管相关性感染反复发作的危险因素单中心分析[J].浙江中西医结合杂志,2022,32(4): |
| 血液透析患者导管相关性感染反复发作的危险因素单中心分析 |
| Single-center analysis of risk factors for catheter-related infections in hemodialysis patients |
| 投稿时间：2021-04-24 修订日期：2021-06-09 |
| DOI： |
| 中文关键词: 血液透析 导管相关性感染 相关因素 预后 |
| 英文关键词:Hemodialysis Catheter-related infection Related factor Outcome |
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| 中文摘要: |
| 目的 探讨血液透析患者导管相关性感染反复发作的危险因素。方法 选取2013年1月1日至2020年8月31日浙江大学医学院附属杭州市第一人民医院收治的90例血液透析患者作为本次研究对象,所有患者均为中心静脉置管,根据导管相关性感染发生次数将患者分为单次组、反复发作组。对可能引发导管相关性感染的危险因素进行统计分析。结果 与单次发作组比较,反复发作组患者基线血白蛋白及血红蛋白较低、首次发生导管相关性感染时透析月龄较长、留置导管时间较长、血白细胞偏高,P值均小于0.05。引发血液透析患者导管相关性感染的致病菌分别是革兰阳性菌(占78.9%)、革兰阴性菌(占20%)、真菌(占1.1%)。Logistic单因素回归分析结果显示,血红蛋白(OR=1.086,P＜0.000)、血白蛋白(OR=1.259,P＜0.000)、BMI(OR=1.153,P＜0.037)、血白细胞(OR=1.122,P＜0.047)、留置导管时长(OR=0.977,P＜0.019)及居住环境(OR=3.716,P＜0.016)为血液透析患者导管相关性感染反复发作的危险因素。Logistic多因素回归结果显示,始透年龄(OR=0.145,P＜0.029)、首次发生感染年龄(OR=6.433,P＜0.031)、血红蛋白(OR=1.151,P＜0.015)、血白蛋白(OR=1.508,P＜0.020)、hs-CRP(OR=0975,P＜0.024)、血白细胞(OR=1.548,P＜0.043)、透析月龄(OR=0.847,P＜0.036)、留置导管时间长(OR=0.909,P＜0.022)、吸烟(OR=0.021,P＜0.022)是血液透析患者导管相关性感染反复发作的独立危险因素。Log-Rank检验结果显示,单次组与反复组患者生存的差异有统计学意义(61.0%比32.7%,c2=4.141,P=0.042)。结论 始透年龄、首次发生感染年龄、血红蛋白、血白蛋白、透析月龄、留置导管时间长、吸烟是血液透析患者导管相关性感染反复发作的独立危险因素。 |
| 英文摘要: |
| OBJECTTIVE To investigate the risk factors for blood dialysis catheter-related infections in patients with recurrent.METHHODS A total of 90 patients with hemodialysis from January 1, 2013 to August 31, 2020 in Affiliated Hangzhou First People’s Hospital Zhejiang University School of Medicine were seletcted as the research objects. All patients had central venous catheterization. Patients were divided into single group and recurrent group according to the frequency of catheter-related infections. Risk factors may lead to catheter-related infections were analyzed.RESULT Compared with the single group, patients in the recurrent group had lower baseline blood albumin and hemoglobin, longer dialysis months at the first occurrence of catheter-related infection, longer catheter indwelling time, and higher white blood cells, all with P values less than 0.05. Lead to blood dialysis catheter-related infections in patients with pathogenic bacteria are gram-positive bacteria (78.9%), gram-negative bacteria (20%), fungi (1.1%). Logistic single factor regression analysis showed that hemoglobin (OR=1.086, P＜0.000), blood albumin (OR=1.259, P＜0.000), BMI (OR=1.153, P＜0.037), white blood cells (OR=1.122, P＜0.047), length of catheter indwelling (OR=0.977, P＜0.019) and living environment (OR=3.716, P＜0.016) were risk factors for recurrent catheter-related infections in hemodialysis patients. Logistic multivariate regression results showed that the age of initiation (OR=0.145, P＜0.029), the age of first infection (OR=6.433, P＜0.031), hemoglobin (OR=1.151, P＜0.015), hemoglobin (OR =1.508, P＜0.020), hs-CRP (OR=0975, P＜0.024), white blood cells (OR=1.548, P＜0.043), age of dialysis months (OR=0.847, P＜0.036), long catheter indwelling time (OR=0.909, P＜0.022), smoking (OR=0.021, P＜0.022) are independent risk factors for recurrent catheter-related infections in hemodialysis patients. Log-Rank test results showed that there was a statistically significant difference in survival between the single group and the repeated group (61.0% vs 32.7%,c2=4.141,P=0.042). CONCLUSION The age of initiation of dialysis, the age of first infection, hemoglobin, hemoglobin, age of dialysis months, long catheterization time, and smoking are independent risk factors for recurrent catheter-related infections in hemodialysis patients. |
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