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目的分析腹膜透析(PD)及血液透析(HD)患者的菌血症发生率以及危险因素,探索更好的预防措施,改善患者的生活质量。方法回顾性分析医院2006年1月-2010年12月维持性透析的224例患者的临床资料,对其菌血症进行统计。结果 224例患者发生菌血症78例,发生率为34.82%;血管通路感染是血液透析患者菌血症主要原因占54.69%,腹膜炎是腹膜透析患者感染菌血症的主要感染部位占57.14%,两者间对比差异有统计学意义(P<0.01);血液透析患者中金黄色葡萄球菌是最常见的病原菌占39.06%,而凝固酶阴性葡萄球菌在腹膜透析患者中最常见占35.71%;腹膜透析患者每年总体菌血症发生率为5.36%,血液透析患者为7.62%;腹膜透析患者感染以凝固酶阴性葡萄球菌最常见占21.27%,血液透析患者感染以金黄色葡萄球菌为主占27.53%;血液透析患者菌血症常见感染部位为血管通路;腹膜炎是腹膜透析患者菌血症的常见感染;年老、透析初期、血液透析相对腹膜透析、使用中心静脉透析导管、糖尿病、低白蛋白血症为菌血症的危险因素。结论开始透析之前建立永久通路(内瘘或腹膜透析置管)、良好的营养状况能减少透析患者感染菌血症的发生。
Objective To analyze the incidence and risk factors of bacteremia in peritoneal dialysis (PD) and hemodialysis (HD) patients and explore better preventive measures to improve the quality of life of patients. Methods The clinical data of 224 patients who underwent maintenance dialysis from January 2006 to December 2010 in our hospital were retrospectively analyzed. Results A total of 78 cases of bacteremia occurred in 224 patients, the incidence rate was 34.82%. Vascular access was the main cause of bacteremia in hemodialysis patients accounting for 54.69%. Peritonitis was the major infectious site of bacteremia in peritoneal dialysis patients accounting for 57.14% There was significant difference between the two groups (P <0.01). Staphylococcus aureus was the most common pathogens in hemodialysis patients, accounting for 39.06%, while coagulase-negative staphylococci accounted for 35.71% Dialysis patients every year the overall incidence of bacteremia was 5.36%, hemodialysis patients was 7.62%; peritoneal dialysis patients infected with coagulase-negative staphylococci accounted for 21.27%, hemodialysis patients with Staphylococcus aureus infection accounted for 27.53% ; Hemodialysis patients with common parts of the bacteremia vascular access; peritonitis is a common infection of peritoneal dialysis patients with bacteremia; age, dialysis, hemodialysis peritoneal dialysis, the use of central venous dialysis catheter, diabetes, hypoalbuminemia Disease is a risk factor for bacteremia. Conclusions To establish permanent access (internal fistula or peritoneal dialysis catheterization) prior to the initiation of dialysis, good nutritional status can reduce the incidence of bacteremia in dialysis patients.