血液透析患者中心静脉导管相关性感染的危险因素分析及临床治疗效果研究(1)
[摘要] 目的 探讨血液透析患者中心静脉导管感染的危险因素和头孢吡肟封管治疗的效果。方法 方便选取2018年6月—2019年6月该院收治血液透析并留置中心静脉导管的患者150例。记录中心静脉导管相关感染的发生率，并分析性别、年龄、穿刺部位、穿刺次数、导管置留时间、基础疾病与发生中心静脉导管相关性感染的关系。对中心静脉导管相关性感染的患者，进行头孢吡肟封管治疗，观察临床治疗效果。结果 在150例研究对象中，发生中心静脉导管相关性感染的例数为34例，发生率22.7%。单因素分析发现年龄、穿刺次数、导管置留时间、基础疾病、血浆白蛋白，差异有统计学意义(χ2=5.438、4.885、8.274、29.968，t=14.293，P<0.05)。多因素分析显示，穿刺次数≥3次、导管置留时间≥2周、基础疾病为糖尿病为引发血液透析患者中心静脉导管相关性感染的独立危险因素(OR>1，P<0.01)。头孢吡肟封管治疗中心静脉导管相关性感染的总有效率为91.2%。结论 穿刺次数多、导管置留时间长、基础疾病为糖尿病是血液透析患者发生中心静脉导管相关性感染的危险因素，头孢吡肟封管治疗中心静脉导管相关性感染有较好的临床疗效。
[关键词] 血液透析;中心静脉导管;危险因素;头孢吡肟
[Abstract] Objective To explore the risk factors of central venous catheter infection and the effect of cefepime tube sealing in hemodialysis patients. Methods From June 2018 to June 2019， 150 patients with hemodialysis and indwelling central venous catheter were conveniently selected in the hospital. The incidence of central venous catheter-related infection was recorded， and the relationship between gender， age， puncture site， number of punctures， catheter retention time， underlying disease， and central venous catheter-related infection was analyzed. Patients with central venous catheter-related infections were treated with cefepime to observe the clinical treatment effect. Results Of the 150 subjects， 34 cases of central venous catheter-related infection occurred， with a incidence rate of 22.7%. Univariate analysis revealed statistically significant differences in age， number of punctures， catheter retention time， underlying disease， and plasma albumin， with significance(χ2=5.438，4.885，8.274，29.968，t=14.293，P<0.05). Multivariate analysis showed that puncture times ≥ 3 times， catheter retention time ≥2 weeks， and diabetes as the underlying disease were independent risk factors for central venous catheter-related infections in hemodialysis patients(OR>1， P<0.01). The total effective rate of cefepime tube sealing for central venous catheter-related infections was 91.2%. Conclusion Multiple punctures， long catheter retention time， and diabetes as the underlying disease are risk factors for central venous catheter-related infections in hemodialysis patients. Cefepime sealing has a good clinical effect on central venous catheter-related infections.
[Key words] Hemodialysis; Central venous catheter; Risk factors; Cefepime
臨床上终末期肾病患者常用的治疗手段是血液透析，通过中心静脉导管建立血液通路是血液透析成功的基础，其具有操作方便、对患者创伤小、血流量大等优点[1-2]。但是其也存在一定的弊端，中心静脉导管置管属于一种侵入性操作，在治疗过程中可能会发生导管相关性感染，致使患者病情加重，严重者可直接危害患者的生命安全[3]。因此，对中心静脉导管相关性感染的危险因素进行分析，并针对性地给予相应的防控措施有着重要的意义。而对于发生中心静脉导管相关性感染的血液透析患者，常使用头孢吡肟封管进行治疗，并有着较好的效果[4]。该文以2018年6月—2019年6月该院收治的150例血液透析并留置中心静脉导管的患者为研究对象，分析中心静脉导管相关性感染的危险因素并探讨头孢吡肟封管的临床治疗效果，现报道如下。, http://www.100md.com(邱承高 张莹 谢婉娜 米兰岚)
[关键词] 血液透析;中心静脉导管;危险因素;头孢吡肟
[Abstract] Objective To explore the risk factors of central venous catheter infection and the effect of cefepime tube sealing in hemodialysis patients. Methods From June 2018 to June 2019， 150 patients with hemodialysis and indwelling central venous catheter were conveniently selected in the hospital. The incidence of central venous catheter-related infection was recorded， and the relationship between gender， age， puncture site， number of punctures， catheter retention time， underlying disease， and central venous catheter-related infection was analyzed. Patients with central venous catheter-related infections were treated with cefepime to observe the clinical treatment effect. Results Of the 150 subjects， 34 cases of central venous catheter-related infection occurred， with a incidence rate of 22.7%. Univariate analysis revealed statistically significant differences in age， number of punctures， catheter retention time， underlying disease， and plasma albumin， with significance(χ2=5.438，4.885，8.274，29.968，t=14.293，P<0.05). Multivariate analysis showed that puncture times ≥ 3 times， catheter retention time ≥2 weeks， and diabetes as the underlying disease were independent risk factors for central venous catheter-related infections in hemodialysis patients(OR>1， P<0.01). The total effective rate of cefepime tube sealing for central venous catheter-related infections was 91.2%. Conclusion Multiple punctures， long catheter retention time， and diabetes as the underlying disease are risk factors for central venous catheter-related infections in hemodialysis patients. Cefepime sealing has a good clinical effect on central venous catheter-related infections.
[Key words] Hemodialysis; Central venous catheter; Risk factors; Cefepime
臨床上终末期肾病患者常用的治疗手段是血液透析，通过中心静脉导管建立血液通路是血液透析成功的基础，其具有操作方便、对患者创伤小、血流量大等优点[1-2]。但是其也存在一定的弊端，中心静脉导管置管属于一种侵入性操作，在治疗过程中可能会发生导管相关性感染，致使患者病情加重，严重者可直接危害患者的生命安全[3]。因此，对中心静脉导管相关性感染的危险因素进行分析，并针对性地给予相应的防控措施有着重要的意义。而对于发生中心静脉导管相关性感染的血液透析患者，常使用头孢吡肟封管进行治疗，并有着较好的效果[4]。该文以2018年6月—2019年6月该院收治的150例血液透析并留置中心静脉导管的患者为研究对象，分析中心静脉导管相关性感染的危险因素并探讨头孢吡肟封管的临床治疗效果，现报道如下。, http://www.100md.com(邱承高 张莹 谢婉娜 米兰岚)