四川凉山地区门诊血液透析事件监测分析
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R197.323 R692

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美国中华医学基金会项目(23-523)


Surveillance of hemodialysis events in outpatient settings in Liangshan District, Sichuan Province
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    摘要:

    目的 了解四川省凉山彝族自治州门诊维持性血液透析患者相关事件发生情况,为该地区感染防控策略制定提供依据。方法 采用前瞻性监测方法,参照疾病控制与预防中心-医疗保健安全网络(CDC-NHSN)及WS/T 312—2023标准,选取凉山彝族自治州3县1市4所公立医院(二级、三级医院各2所)。监测2024年3月—2025年3月每个月前两个工作日接受血液透析治疗的患者,共纳入826例患者(8 675例次)。由透析中心感染控制小组采用标准化表格收集数据并进行统计分析。结果 监测期间,血液透析事件发生率为5.15%(447/8 675)。其中,非隧道式导管患者的事件发生率(16.67%,36/216)和病死率(10.00%,4/40)均为各通路类型中最高;带隧道导管患者的住院率(42.86%)最高。全身抗菌药物使用占82.33%(368/447),以上呼吸道感染为主(38.32%);血管通路穿刺部位感染占16.78%(75/447);血培养阳性4例(0.89%,4/447)。结论 四川省凉山彝族自治州门诊维持性血液透析患者中,全身抗菌药物使用和血管通路穿刺部位感染是最常见的事件类型;非隧道式导管患者的血液透析事件发生率最高。

    Abstract:

    Objective To investigate the occurrence of hemodialysis events in patients who received maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province, and provide basis for the formulation of infection prevention and control strategies in this area. Methods Based on the standards from Center for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) as well as the WS/T 312-2023 standards, four public hospitals (two secondary and two tertiary hospitals) in three counties and one city of Liangshan Yi Autonomous Prefecture were selected, and prospective surveillance method was adopted. A total of 826 patients (n=8 675 cases) who received maintenance hemodialysis on the first two working day of each month from March 2024 to March 2025 were surveilled. Data were collected with standardized form by infection control teams in dialysis centers. Statistical analysis was conducted. Results During the surveillance period, the incidence of hemodialysis events was 5.15% (447/8 675). The incidence (16.67%, 36/216) and mortality (10.00%, 4/40) of hemodialysis events in patients with non-tunneled catheters were the highest among patients with all types of access. Patients with tunneled-catheters had the highest hospitalization rate (42.86%). Systemic use of antimicrobial agents accounted for 82.33% (368/447). Upper respiratory tract infection was the main infection (38.32%). Infection at the puncture site of vascular access accounted for 16.78% (75/447). Four cases (0.89%, 4/447) had positive blood culture. Conclusion Systemic antimicrobial use and infection at vascular access puncture site is the most frequent events in patients who receive maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province. Patients with non-tunneled catheters have the highest rate of hemodialysis events.

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蒋衣果,兰安群,邓忠琴,等.四川凉山地区门诊血液透析事件监测分析[J]. 中国感染控制杂志,2025,24(10):1416-1423. DOI:10.12138/j. issn.1671-9638.20252575.
JIANG Yiguo, LAN Anqun, DENG Zhongqin, et al. Surveillance of hemodialysis events in outpatient settings in Liangshan District, Sichuan Province[J]. Chin J Infect Control, 2025,24(10):1416-1423. DOI:10.12138/j. issn.1671-9638.20252575.

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  • 收稿日期:2025-05-30
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  • 在线发布日期: 2025-10-29
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