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。
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.
作者
邱承高
张莹
谢婉娜
米兰岚
QIU Cheng-gao;ZHANG Ying;XIE Wan-na;MI Lan-lan(Department of Nephrology,Wuzhou Workers Hospital,Wuzhou,Guangxi,543000 China;Department of Oncology,Wuzhou Workers Hospital,Wuzhou,Guangxi,543000 China)
出处
《中外医疗》
2020年第11期40-42,45,共4页
China & Foreign Medical Treatment
