基于信息化的单中心门诊血液透析事件监测
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茅一萍

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R181.3+2

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Information-based surveillance of dialysis events in an outpatient department
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    摘要:

    目的 在应用监测软件的基础上了解门诊血液透析事件的发病率。方法 参照美国国家医疗保健安全网络(NHSN)血液透析事件监测手册,依托门诊血液透析事件监测软件,监测2017年1-12月每个月前2个工作日在某院血液透析中心进行维持性血液透析患者发生的血液透析事件的情况。结果 2017年1-12月共监测门诊血液透析患者4 006例次,发生血液透析事件138例次,血液透析事件发生率为3.44%,其中使用抗菌药物130例次(静脉52例次,口服78例次),血培养阳性4例次,血管穿刺部位感染4例次。按不同血管通路类型分类,其血液透析事件发生率最高的为非隧道式中央导管(7.33%)。130例使用抗菌药物的患者共发生179例次感染,主要为上呼吸道感染(94例次)。2017年各月份血液透析事件发生率呈先升高后下降的趋势,4月份发生率最高,为19.02%。结论 门诊血液透析事件以全身使用抗菌药物为主,非隧道式中央静脉导管患者血液透析事件发生率较高,信息化监测可作为门诊血液透析事件监测的手段。

    Abstract:

    Objective To investigate the incidence of hemodialysis events in an outpatient department on the basis of application of monitoring software. Methods According to National Healthcare Safety Network (NHSN) hemodialysis event monitoring manual, and relying on the outpatient hemodialysis event monitoring software, the occurrence of hemodialysis events in patients undergoing hemodialysis maintenance in hemodialysis center in a hospital at the first two working days in each month from January to December 2017 were monitored. Results From January to December 2017, a total of 4 006 hemodialysis patients were monitored, 138 dialysis events occurred, incidence of hemodialysis events was 3.44%, 130 of which were treated with antimicrobial agents (52 intravenously, 78 orally), 4 cases were positive for blood culture, and 4 cases were infected at blood vessel puncture site. Accor-ding to different types of vascular access, the highest incidence of hemodialysis events was non-tunnel central catheter (7.33%). Among 130 patients who received antimicrobial agents, a total of 179 cases of infection occurred, mainly upper respiratory tract infection (94 cases). Incidence of hemodialysis events increased firstly and then decreased in each month of 2017, with the highest rate (19.02%) in April. Conclusion Outpatient hemodialysis events are mainly caused by systemic use of antimicrobial agents, incidence of hemodialysis events in non-tunnel central venous catheter patients is high, information monitoring can be used as a mean of monitoring outpatient hemodialysis events.

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张冰, 茅一萍, 刘秉诚,等.基于信息化的单中心门诊血液透析事件监测[J]. 中国感染控制杂志,2019,18(7):638-642. DOI:10.12138/j. issn.1671-9638.20194218.
ZHANG Bing, MAO Yi-ping, LIU Bing-cheng, et al. Information-based surveillance of dialysis events in an outpatient department[J]. Chin J Infect Control, 2019,18(7):638-642. DOI:10.12138/j. issn.1671-9638.20194218.

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  • 收稿日期:2018-09-03
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  • 在线发布日期: 2019-07-28
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