中国急救医学
中國急救醫學
중국급구의학
Chinese Journal of Critical Care Medicine
2015年
10期
888-891
,共4页
CRRT%医院获得性肺炎%病原菌%相关因素
CRRT%醫院穫得性肺炎%病原菌%相關因素
CRRT%의원획득성폐염%병원균%상관인소
Continuous renal replacement therapy(CRRT)%Hospital acquired pneumonia%Pathogen%Related factors
目的：探讨连续性肾脏替代治疗（ CRRT）患者医院获得性肺炎病原学特点及相关因素。方法采用回顾性研究方法，选取2009－09～2014－07恩施州中心医院血透中心进行CRRT患者580例，分析并发肺部感染的病原菌、感染率及相关因素。结果580例CRRT患者中发生医院获得性肺炎58例，感染率为10．0％。病原菌以葡萄球菌感染为主。年龄、治疗时间、基础疾病、吞咽障碍、器官衰竭数目、意识障碍、预防应用抗菌药与CRRT患者并发肺部感染相关（P＜0．05）。其中年龄≥60岁（β＝0．59，OR＝3．79）、治疗时间≥24 h（β＝1．12，OR＝2．46）、基础疾病≥2种（β＝2．79，OR＝4．10）、器官衰竭数目≥3种（β＝3．284，OR＝12．70）、意识障碍（β＝2．35，OR＝3．26）是CRRT患者并发肺部感染的危险因素。预防应用抗菌药物（β＝－1．72，OR＝0.18）是CRRT患者并发肺部感染的保护因素。结论 CRRT患者并发肺部感染与多种因素密切相关，临床应针对性地采取预防及干预措施，有效控制医院感染的发生，提高患者治疗的安全性。
目的：探討連續性腎髒替代治療（ CRRT）患者醫院穫得性肺炎病原學特點及相關因素。方法採用迴顧性研究方法，選取2009－09～2014－07恩施州中心醫院血透中心進行CRRT患者580例，分析併髮肺部感染的病原菌、感染率及相關因素。結果580例CRRT患者中髮生醫院穫得性肺炎58例，感染率為10．0％。病原菌以葡萄毬菌感染為主。年齡、治療時間、基礎疾病、吞嚥障礙、器官衰竭數目、意識障礙、預防應用抗菌藥與CRRT患者併髮肺部感染相關（P＜0．05）。其中年齡≥60歲（β＝0．59，OR＝3．79）、治療時間≥24 h（β＝1．12，OR＝2．46）、基礎疾病≥2種（β＝2．79，OR＝4．10）、器官衰竭數目≥3種（β＝3．284，OR＝12．70）、意識障礙（β＝2．35，OR＝3．26）是CRRT患者併髮肺部感染的危險因素。預防應用抗菌藥物（β＝－1．72，OR＝0.18）是CRRT患者併髮肺部感染的保護因素。結論 CRRT患者併髮肺部感染與多種因素密切相關，臨床應針對性地採取預防及榦預措施，有效控製醫院感染的髮生，提高患者治療的安全性。
목적：탐토련속성신장체대치료（ CRRT）환자의원획득성폐염병원학특점급상관인소。방법채용회고성연구방법，선취2009－09～2014－07은시주중심의원혈투중심진행CRRT환자580례，분석병발폐부감염적병원균、감염솔급상관인소。결과580례CRRT환자중발생의원획득성폐염58례，감염솔위10．0％。병원균이포도구균감염위주。년령、치료시간、기출질병、탄인장애、기관쇠갈수목、의식장애、예방응용항균약여CRRT환자병발폐부감염상관（P＜0．05）。기중년령≥60세（β＝0．59，OR＝3．79）、치료시간≥24 h（β＝1．12，OR＝2．46）、기출질병≥2충（β＝2．79，OR＝4．10）、기관쇠갈수목≥3충（β＝3．284，OR＝12．70）、의식장애（β＝2．35，OR＝3．26）시CRRT환자병발폐부감염적위험인소。예방응용항균약물（β＝－1．72，OR＝0.18）시CRRT환자병발폐부감염적보호인소。결론 CRRT환자병발폐부감염여다충인소밀절상관，림상응침대성지채취예방급간예조시，유효공제의원감염적발생，제고환자치료적안전성。
Objective To explore the infectious pathogen and related factors of hospital acquired pneumonia in continuous renal replacement therapy ( CRRT ) and providing the basis for the development of nursing measures and intervention measures . Methods In order to analyze the incidence of nosocomial infections and pathogen and the related factors , this retrospective investigation collected the clinical data from 580 CRRT patients who were hospitalized to the center of hemodialysis units of our university from Sep .2009 to July.2014.Results The nosocomial infections were occurred in 58 cases of the 580 cases, and the infectious rate was 10.0%;the main pathogen was staphyloccocus aureus;the related factors (P<0.05) included age, therapy times, the basis of disease, dysphagia, the number of organ failure , disorder of consciousness , preventive application of antibiotics , and the risk factors included the age which is greater than or equal to sixty years (β=0.59, OR=3.79), therapy times which is greater than or equal to twenty four hours (β=1.12, OR=2.46), the basis of disease which is greater than or equal to twice types (β=2.79, OR=4.10), the number of organ failure (β=3.284, OR=12.70), disorder of consciousness which is holding (β=2.35, OR=3.26) and the protective factors including preventive application of antibiotics (β=-1.72, OR =0.18 ) were analyzed.Conclusion The hospital acquired pneumonia in CRRT patients is closely related to the number of factors .The appropriate intervention measures should be taken clinically to effectively control the occurrence of infections and enhance the treatment safety of patients .
