【作者】 蓝天座； 于黔； 杨雯； 黎懿慧； 黄健；

【Author】 Lan Tianzuo;Yu Qian;Li Yihui;Yangwen;Huangjian;Department of Nephrology,Guiyang First People’s Hospital;

【机构】 贵阳市第一人民医院肾内科；

【摘要】 目的探讨维持性血液透析患者中心静脉置管感染的相关因素。方法选取2013年1月至12月在贵阳市第一人民医院肾内科行中心静脉置管的维持性血透患者92例,根据置管部位,血浆总蛋白水平(TP)、白蛋白水平(ALB)、体重指数(BMI)、C反应蛋白(CRP)、血清肿瘤坏死因子(TNF-α)、白介素-6 (IL-6)表达,合并糖尿病及年龄等因素分组研究导管感染率的发生。结果股静脉置管感染率高于颈内静脉,分别为32.6%和12.5%,χ~2=6.612,p<0.05。营养指标(血浆总蛋白、白蛋白、体重指数)影响血液透析患者导管感染率(p<0.05)。血浆细胞因子水平(CRP、TNF-α、IL-6)的表达对中心静脉置管感染的发生有早期预测作用(p<0.05)。糖尿病肾病患者感染率高于非糖尿病肾病患者,分别为38.3%,17.2%,x2=6.422,p<0.05。感染组与非感染组年龄分别为65.80+10.82岁和65.75+10.23岁,t=-0.218,p>0.05,无统计学意义。结论维持性血液透析患者中心静脉置管感染与置管部位、营养状况、微炎症状态、合并糖尿病密切相关,早期采取措施预防导管感染可减少中心静脉置管患者感染的发生,延长导管使用寿命。更多还原

【Abstract】 Object To explore the factors relating to cather infection in maintain hemodialysis patients with temporary central vein catherization.Methods Ninty-two maintain hemodialysis patients with temporary central vein catheter and treated in the period of January to December 2013 in our hospital were retrospectively surveyed.Patients were devided into several groups according to position of the catheter,nutrition indicators(hemoglobin and albumin,BMI),CRP,IL-6,TNF-α,IL-6,diabetes,age.Their catheter infection rate was investigated.Results The catheter infection rate was higher in femoral vein(32.6%) than in jugular vein(12.5%,x2=6.612,p<0.05).The catheter infection rate was also influenced by the nutrition indicators of hemoglobin and albumin(p<0.05),and was higher in patients of microinflammtory status(p<0.05).The catheter infection rate was higher in patients with diabetes(38.3%) than those without diabetes(17.2%,x2=6.420,p<0.05),but not influenced by age(p<0.05).Conclusion Catheter infection in maintain hemodialysis patients with temporary central vein cathetrization was related to position of the catheter,nutrition status,microinfiammtory status,diabetes.We should take measures in advance to prevent catheter infection in hemodialysis patients and prolong the use of temporary central vein catheterization.更多还原