CAJ | 학술논문

目的：探讨老年慢性肾衰竭维持性血液透析患者发生医院感染部位分布及相关危险因素，为降低医院感染率提供依据。方法回顾性分析2011年1月－2014年12月120例老年慢性肾衰竭维持性血液透析患者临床资料，分析其感染部位及相关危险因素，采用SPSS18．0软件进行统计分析。结果120例老年慢性肾衰竭维持性血液透析患者发生医院感染42例，感染率为35．0％，感染部位以导管感染为主，占30．95％，其次为呼吸道、消化道、泌尿系统，分别占26．19％、23．81％、9．52％；老年慢性肾衰竭维持性血液透析患者发生医院感染后均给予抗感染治疗，疗程（13．6±4．2）d ，统计各感染部位抗感染治疗时间及住院时间，各组比较差异无统计学意义；多因素 logistic回归分析显示，住院时间、伴有糖尿病、血红蛋白、血白蛋白、中心静脉置管等因素是发生医院感染的独立危险因素。结论老年慢性肾衰竭维持性血液透析患者发生医院感染相关危险因素较多，临床应采取针对性干预措施，加强血液透析室医务人员感染管理及规范操作，加强治疗老年患者基础疾病，以降低血液透析室患者医院感染率。
목적：탐토노년만성신쇠갈유지성혈액투석환자발생의원감염부위분포급상관위험인소，위강저의원감염솔제공의거。방법회고성분석2011년1월－2014년12월120례노년만성신쇠갈유지성혈액투석환자림상자료，분석기감염부위급상관위험인소，채용SPSS18．0연건진행통계분석。결과120례노년만성신쇠갈유지성혈액투석환자발생의원감염42례，감염솔위35．0％，감염부위이도관감염위주，점30．95％，기차위호흡도、소화도、비뇨계통，분별점26．19％、23．81％、9．52％；노년만성신쇠갈유지성혈액투석환자발생의원감염후균급여항감염치료，료정（13．6±4．2）d ，통계각감염부위항감염치료시간급주원시간，각조비교차이무통계학의의；다인소 logistic회귀분석현시，주원시간、반유당뇨병、혈홍단백、혈백단백、중심정맥치관등인소시발생의원감염적독립위험인소。결론노년만성신쇠갈유지성혈액투석환자발생의원감염상관위험인소교다，림상응채취침대성간예조시，가강혈액투석실의무인원감염관리급규범조작，가강치료노년환자기출질병，이강저혈액투석실환자의원감염솔。
OBJECTIVE To explore the related risk factors for nosocomial infections in elderly patients with chronic renal failure patients undergoing maintenance hemodialysis and observe the nosocomial infection sites so as to re‐duce the incidence of nosocomial infections .METHODS A total of 120 elderly patients with chronic renal failure who underwent the maintenance hemodialysis from Jan 2011 to Dec 2014 were enrolled in the study ,then the clini‐cal data of the participants were retrospectively analyzed ,the infection sites and related risk factors for the infec‐tions were observed ,and the statistical analysis was performed with the use of SPSS18 .0 software .RESULTS The nosocomial infections occurred in 42 of 120 elderly patients with chronic renal failure undergoing maintenance he‐modialysis ,with the infection rate of 35 .0% .Of the patients with nosocomial infections ,30 .95% had the cathe‐ter‐related infections ,26 .19% had the respiratory tract infections ,23 .81% had the gastrointestinal tract infec‐tions ,and 9 .52% had the urinary tract infections .The anti‐infection treatment was conducted for the elderly pa‐tients with chronic renal failure undergoing maintenance hemodialysis ,with the mean treatment course of (13 .6 ± 4 .2) day .There was no significant difference in the time of treatment of the nosocomial infections or the length of hospital stay .The multivariate logistic regression analysis indicated that the length of hospital stay ,complication of diabetic mellitus ,hemoglobin ,albumin ,and central venous catheter indwelling were the independent risk fac‐tors for the nosocomial infections .CONCLUSION There are a variety of risk factors for the nosocomial infections in the elderly patients with chronic renal failure undergoing maintenance hemodialysis .It is necessary for the health care workers of the hemodialysis room to take targeted interventions ,strengthen the control of infections and standard operation ,and enhance the treatment of underling diseases in the elderly patients so as to reduce the inci‐dence of nosocomial infections in the patients undergoing hemodialysis .