腹膜透析患者医院感染因素分析与对策

Causes and countermeasures for nosocomial infections in patients undergoing peritoneal dialysis

  • 摘要: 目的 分析腹膜透析患者医院感染发生的原因及对策,为降低腹膜透析患者医院感染提供参考依据。方法 收集2013年1月-2015年8月住院行腹膜透析治疗260例患者临床资料,记录患者性别、年龄、住院时间、腹膜透析龄、基础疾病、合并症、血红蛋白及血清白蛋白水平、有无发生医院感染及医院感染部位等资料,对所有数据采用SPSS19.0软件进行统计分析。结果 36例患者发生医院感染,感染率13.85%,感染部位主要为呼吸道占44.44%,其次为泌尿道、皮肤黏膜、腹膜、胃肠道、血液,分别占22.22%、13.90%、8.33%、8.33%、2.78%;有合并症患者医院感染率19.15%,高于无合并症患者的9.66%,多因素logistic回归分析显示,患者年龄、腹膜透析龄、血红蛋白及血清白蛋白水平低、有合并症,是患者发生医院感染的独立影响因素,差异有统计学意义(P<0.05)。结论 腹膜透析患者发生医院感染的影响因素较多,应针对感染相关因素进行干预,降低患者发生医院感染率。

     

    Abstract: OBJECTIVE To explore the causes and countermeasures for nosocomial infections in patients undergoing peritoneal dialysis so as to reduce the incidence of nosocomial infections in the patients undergoing peritoneal dialysis. METHODS The clinical data were collected from 260 patients who were hospitalized for peritoneal dialysis from Jan 2013 to Aug 2015, then the gender, age, length of hospital stay, peritoneal dialysis age, underlying diseases, complications, levels of hemoglobin and serum albumin, incidence of nosocomial infections, and nosocomial infection sites were recorded, and the statistical analysis of data was performed with the use of SPSS19.0 software. RESULTS The nosocomial infections occurred in 36 patients, with the infection rate 13.85%. Of the patients with nosocomial infections, 44.44% had respiratory tract infections, 22.22% had urinary tract infections, 13.90% had skin and mucous membrane infections,8.33% had peritoneal infections, 8.33% had gastrointestinal tract infections, and 2.78% had blood infections. The incidence of nosocomial infections was 19.15% in the patients with complications, higher than 9.66% in the patients without complications. The multivariate logistic regression analysis indicated that the independent risk factors for the nosocomial infections included the age, peritoneal dialysis age, low levels of hemoglobin and serum albumin, and complications (P<0.05). CONCLUSION There are a variety of influencing factors for the nosocomial infections in the patients undergoing the peritoneal dialysis. It is necessary to take interventions aiming at the related factors for the infections so as to reduce the incidence of the nosocomial infections.

     

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