维持性血液透析患者肺部感染的危险因素分析

发布时间：2019-06-14 03:16

【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。
[Abstract]:Objective to investigate the risk factors of pulmonary infection in maintenance hemodialysis patients and to provide reference for clinical prevention and treatment. Methods from January 2007 to December 2011, 100 patients undergoing maintenance hemodialysis for 6 months were divided into infection group (n = 40) and uninfected group (n = 60) according to whether or not pulmonary infection occurred. The bacteriological results of patients with pulmonary infection were observed, and the clinical data of biochemical indexes and imaging indexes were compared between the two groups in order to explore the risk factors of pulmonary infection in maintenance hemodialysis patients. Results in the infection group, all the 40 patients were treated with sputum specimens for bacteriological examination, 19 cases were positive for bacterial culture, the positive rate was 47.50%, Gram-negative bacteria were more common, the first three were Klebsiella pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae, accounting for 26.32%, 15.79% and 10.53%, respectively, and the bacterial culture was positive in 19 cases, the positive rate was 47.50%, the first three were Klebsiella pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae, respectively. Advanced age, diabetes mellitus, moderate and severe anemia, inadequate dialysis, malnutrition and high cardiothoracic ratio are the risk factors of pulmonary infection in maintenance hemodialytic patients. Conclusion according to the risk factors of maintenance hemodialysis complicated with pulmonary infection, attention should be paid to the control of blood glucose level, correction of anemia, supplementary nutrition, adequate dialysis and reduction of cardiac volume load in order to reduce the risk of pulmonary infection and improve the prognosis of patients.
【作者单位】：浙江省舟山医院血液净化中心;
【基金】：舟山市科技计划基金资助项目(2011C13043)
【分类号】：R563.1

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