老年慢性肾衰竭维持性血液透析患者医院感染相关因素分析(1)
[摘要]目的 探讨老年慢性肾衰竭维持性血液透析患者医院感染的相关因素。方法 选取我院2017年5月～2018年10月收治的90例老年慢性肾衰竭维持性血液透析患者作为研究对象，采取面对面交谈法掌握受检人员基本情况，评估90例老年慢性肾衰竭维持性血液透析患者的医院感染率，分析感染相关因素。结果 90例老年慢性肾衰竭维持性血液透析患者的医院感染率为40.00%，其中呼吸道感染15例，泌尿系统感染10例，中心静脉置管相关感染3例，肠道感染6例，其他部位感染2例。90例患者在性别方面比较，差异无统计学意义(P>0.05);而年龄、贫血、低蛋白血症、糖尿病肾病、心功能不全、中心静脉插管、透析时间等比较，差异有统计学意义(P<0.05)。Logistic回归分析显示，低蛋白血症、年龄、贫血、透析时间、心功能不全、糖尿病肾病、中心静脉插管均是医院感染发生的独立危险因素(P<0.05)。结论 临床上应尽量减少不必要的有创医疗手段治疗，且通过加强患者营养支持及科室感染控制，达到避免医源性感染发生的目的。
[关键词]老年;慢性肾衰竭维持性血液透析;医院感染;相关因素
[中图分类号] R692.5 [文献标识码] A [文章编号] 1674-4721(2019)7(a)-0103-03
[Abstract] Objective To investigate the related factors of nosocomial infection in elderly patients with chronic renal failure undergoing maintenance hemodialysis. Methods A total of 90 elderly patients with chronic renal failure undergoing maintenance hemodialysis in our hospital from May 2017 to October 2018 were selected as the subjects of study. The face-to-face interview method was used to grasp the basic situation of the examinee， the nosocomial infection rate of 90 elderly patients with chronic renal failure undergoing maintenance hemodialysis were evaluated， and the related factors of infection were analyzed. Results The hospital infection rate of 90 elderly patients with chronic renal failure maintenance hemodialysis was 40.00%， including 15 respiratory infections， 10 urinary tract infections， 3 central venous catheter infections， and 6 intestinal infections， and there were 2 cases of infection in other parts. There was no significant difference in gender between 90 patients (P>0.05). There were significant differences in age， anemia， hypoproteinemia， diabetic nephropathy， cardiac insufficiency， central venous intubation， and dialysis time (P<0.05). Logistic regression analysis showed that hypoproteinemia， age， anemia， dialysis time， cardiac insufficiency， diabetic nephropathy， and central venous intubation were independent risk factors for nosocomial infection (P<0.05). Conclusion In clinic， unnecessary invasive medical treatment should be reduced as far as possible， and the aim of avoiding iatrogenic infection can be achieved by strengthening patients′ nutritional support and infection control in departments.
[Key words] The elderly; Chronic renal failure maintenance hemodialysis; Nosocomial infection; Related factors
老年慢性腎衰竭是临床上较为常见的疾病之一，具有较高的发病率及病死率。随着疾病的发展，其可在一定程度上降低患者肾小球滤过率及破坏肾单位，最终造成不可逆的肾损伤，甚至肾衰竭，为此尽早实施有效方法治疗十分重要，其对改善患者生存质量及预后具有积极作用。目前，临床上常采用维持性血液透析方法治疗本病，其是延长患者寿命的主要手段[1]。但是经调查发现，部分患者在治疗过程中可发生医院感染事件，这是导致该类患者死亡的主要因素，为此临床上对于该现象的发生需加以重视，积极查找医院感染的相关因素，通过实施相应干预措施以达到降低医院感染发生率的目的，对促进患者康复具有积极作用[2]。为了探讨老年慢性肾衰竭维持性血液透析患者医院感染相关因素，选取我院收治的90例研究老年慢性肾衰竭维持性血液透析患者作为对象进行研究，现报道如下。, http://www.100md.com(邓真真)
[关键词]老年;慢性肾衰竭维持性血液透析;医院感染;相关因素
[中图分类号] R692.5 [文献标识码] A [文章编号] 1674-4721(2019)7(a)-0103-03
[Abstract] Objective To investigate the related factors of nosocomial infection in elderly patients with chronic renal failure undergoing maintenance hemodialysis. Methods A total of 90 elderly patients with chronic renal failure undergoing maintenance hemodialysis in our hospital from May 2017 to October 2018 were selected as the subjects of study. The face-to-face interview method was used to grasp the basic situation of the examinee， the nosocomial infection rate of 90 elderly patients with chronic renal failure undergoing maintenance hemodialysis were evaluated， and the related factors of infection were analyzed. Results The hospital infection rate of 90 elderly patients with chronic renal failure maintenance hemodialysis was 40.00%， including 15 respiratory infections， 10 urinary tract infections， 3 central venous catheter infections， and 6 intestinal infections， and there were 2 cases of infection in other parts. There was no significant difference in gender between 90 patients (P>0.05). There were significant differences in age， anemia， hypoproteinemia， diabetic nephropathy， cardiac insufficiency， central venous intubation， and dialysis time (P<0.05). Logistic regression analysis showed that hypoproteinemia， age， anemia， dialysis time， cardiac insufficiency， diabetic nephropathy， and central venous intubation were independent risk factors for nosocomial infection (P<0.05). Conclusion In clinic， unnecessary invasive medical treatment should be reduced as far as possible， and the aim of avoiding iatrogenic infection can be achieved by strengthening patients′ nutritional support and infection control in departments.
[Key words] The elderly; Chronic renal failure maintenance hemodialysis; Nosocomial infection; Related factors
老年慢性腎衰竭是临床上较为常见的疾病之一，具有较高的发病率及病死率。随着疾病的发展，其可在一定程度上降低患者肾小球滤过率及破坏肾单位，最终造成不可逆的肾损伤，甚至肾衰竭，为此尽早实施有效方法治疗十分重要，其对改善患者生存质量及预后具有积极作用。目前，临床上常采用维持性血液透析方法治疗本病，其是延长患者寿命的主要手段[1]。但是经调查发现，部分患者在治疗过程中可发生医院感染事件，这是导致该类患者死亡的主要因素，为此临床上对于该现象的发生需加以重视，积极查找医院感染的相关因素，通过实施相应干预措施以达到降低医院感染发生率的目的，对促进患者康复具有积极作用[2]。为了探讨老年慢性肾衰竭维持性血液透析患者医院感染相关因素，选取我院收治的90例研究老年慢性肾衰竭维持性血液透析患者作为对象进行研究，现报道如下。, http://www.100md.com(邓真真)