摘要
目的探讨维持性血液透析患者肺部感染的危险因素,为临床有针对性地预防治疗提供参考依据。方法选取2007年1月-2011年12月在血液净化室接受维持性血液透析治疗>6个月的100例患者,根据其是否发生肺部感染分为感染组40例和未感染组60例,观察肺部感染患者的细菌学检查结果,对比两组患者的生化指标、影像学指标等临床资料,以探讨维持性血液透析患者合并肺部感染的危险因素。结果感染组40例患者确诊后均给予留取痰标本行细菌学检测,细菌培养阳性19例,阳性率为47.50%;感染病原菌以革兰阴性菌较为多见,前3位为肺炎克雷伯菌、铜绿假单胞菌、流感嗜血菌,分别占26.32%、15.79%、10.53%;高龄、糖尿病、中重度贫血、透析不充分、营养不良以及心胸比例高是维持性血液透析患者合并肺部感染的危险因素。结论根据维持性血液透析合并肺部感染的危险因素,临床上应注意控制患者血糖水平、纠正贫血、补充营养,尽量充分透析以及降低心脏容量负荷,以降低患者发生肺部感染的风险,改善患者预后。
OBJECTIVE To investigate the risk factors of maintenance hemodialysis patients complicated with pulmonary infections, so as to offer certain reference basis for prevention and control. METHODS A total of 100 patients received maintenance hemodialysis treatment in laminar airflow room longer than 6 months from Jan. 2007 to Dec. 2011 were selected in our hospital. According to the patients with pulmonary infections, they were divided into the infection group （40 cases） and non-infection group （60 cases）, the bacteriological examination results of patients with pulmonary infections were observed, and the clinical data and biochemical indexes were compared between two groups of indicators to evaluate risk factors of maintenance hemodialysis. RESULTS The 40 patients in infection group with a definite diagnosis all had a detection of bacteriology about their sputum specimens, among which there were 19 positive ones, accounting for 47.50%. The gram-negative bacteria were more common of the pathogenic bacteria of pulmonary infections. The top three pathogenic bacteria were Klebsiella pneumoniae （26.32%）, Streptococcus pneumoniae （15. 79%）-and Hemophilus influenzae （10. 53%）. Elderly, diabetes, anaemia, inadequate dialysis, malnutrition and high cardiothoracic ratio were the risk factors of maintenance hemodialysis patients complicated with pulmonary infections. CONCLUSIONS According to the risk factors of hemodialysis patients with lung infection, we should pay attention to the control of blood glucose level, anemia improvement, nutritional supplements, reducing cardiac volume load by adequate dialysis as far as possible, in order to reduce the incidence of pulmonary infections in patients with the risk, improve the prognosis of the patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第11期2706-2708,共3页
Chinese Journal of Nosocomiology
基金
舟山市科技计划基金资助项目(2011C13043)
关键词
维持性血液透析
肺部感染
危险因素
Maintenance hemodialysis
Pulmonary infection
Risk factors
