【摘要】 目的:分析慢性肾脏病(CKD)并发脓毒血症的临床特征,为临床诊治提供依据。方法:回顾性分析慢性肾脏病并发脓毒血症40例的临床病历资料。结果:在40例CKD的患者中,肾衰竭30例(75%),深静脉置管22例(55%),使用免疫抑制剂和糖皮质激素12例(30%),18例患者合并泌尿系统和呼吸系统感染。分离的病原菌中,大肠埃希菌13例,金黄色葡萄球菌(金葡菌)11例(60%),其它16例;有4例(10%)合并了真菌感染。金葡菌对青霉素G均耐药,对环丙沙星和克林霉素耐药>50%。死亡8例,32例经有效抗生素治疗3～4周康复。结论:CKD患者易罹患脓毒血症,除与贫血、低蛋白血症和其它的感染因素有关外,与肾功能的下降、深静脉留置导管和免疫抑制剂的应用相关。更多还原

【Abstract】 Objective:To analyze the clinical characteristics of chronic kidney disease (CKD) complicated with sepsis in order to provide evidence for clinical diagnosis and treatment.Methods:Clinical data of 40 cases with CKD complicated with sepsis were analyzed retrospectively.Results:Among 40 cases with CKD,30 cases were with renal failure (75%),22 cases (55%) received deep vein catheterization,12 cases (30%) treated with immunosuppressant,18 patients complicated with urinary or respiratory tract infection.Of the isolated pathogens,13 were Escherichia coli,11 were staphylococcus aureus,16 with others;4 cases (10%) complicated with fungus infection.All of the infected staphylococcus aureus were resistant to penicillin,more than 50% of them were resistant to ciprofloxacin and clindamycin.8 cases died,32 cases were cured after effective treatment with antibiotics for 3~4 weeks.Conclusions:Patients with CKD are prone to have sepsis.Except anemia,hypoalbuminemia and other infections,decreased kidney function,deep vein catheterization and application of immunosuppressant are also the risk factors.更多还原