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目的探讨终末期肾病(End stage renal disease,ESRD)患者长期血液透析造成管路感染的原因及防范措施。方法选取2014年5月—2016年5月收治的ESRD行长期(>6个月)血液透析治疗的患者182例,分析管路感染情况及相关影响因素并提出预防措施。ERSD患者长期血液透析管路感染影响因素采用单因素分析和Logistic多因素回归分析,P<0.05为差异有统计学意义。结果 182例患者中,发生管路感染者18例,感染率9.89%;年龄、肥胖、血清白蛋白、导管留置部位、糖尿病、分机分区透析、长期服用抗生素、长期使用免疫抑制剂、C-反应蛋白均是ERSD患者长期血液透析管路感染的影响因素(均P<0.05);多因素Logistic回归分析显示,血清白蛋白<30 g、股静脉导管留置、糖尿病是影响ERSD患者长期血液透析管路感染的独立危险因素。结论股静脉导管留置、血清白蛋白<30 g、伴有糖尿病是影响ERSD患者长期血液透析管路感染的独立危险因素,采取相应的防治措施能积极帮助ERSD患者防治长期血液透析引发的管路感染。
Objective To investigate the causes of long-term hemodialysis caused by end-stage renal disease (ESRD) and its preventive measures. Methods From May 2014 to May 2016, 182 long-term (> 6 months) ESRD patients treated by hemodialysis were enrolled in this study. Tuberculosis infection and related factors were analyzed and preventive measures were proposed. Long-term hemodialysis patients with ERSD infection factors affecting the use of univariate analysis and Logistic regression analysis, P <0.05 for the difference was statistically significant. Results In 182 patients, 18 cases were infected by pipeline, the infection rate was 9.89%; age, obesity, serum albumin, catheter indwelling site, diabetes mellitus, dialysis in extension, long-term use of antibiotics, long- (All P <0.05). Multivariate Logistic regression analysis showed that serum albumin <30 g, indwelling femoral vein catheter and diabetes mellitus were the risk factors of long-term hemodialysis line in ERSD patients Independent risk factors for infection. Conclusion Femoral catheter indwelling, serum albumin <30 g, associated with diabetes mellitus is an independent risk factor for long-term hemodialysis in ERSD patients, taking appropriate prevention and treatment measures can help ERSD patients with long-term hemodialysis-induced tuberculosis infection .