无隧道和涤纶套的透析导管相关血流感染危险因素病例对照研究
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R181.3+2

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Risk factors for bloodstream infection related to non-cuffed catheter of hemodialysis: a case-control study
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    摘要:

    目的 探讨无隧道和涤纶套的透析导管(NCC)相关血流感染的危险因素,为血液透析患者导管相关血流感染(CRBSI)防控提供依据。方法 选择2015年1月—2024年12月就诊于某院肾内科采用NCC执行血液透析并发生CRBSI的127例住院患者为病例组,按照1∶2的匹配比例,以性别、肾衰竭类型和NCC置管时间±30 d为匹配条件,选取采用NCC执行血液透析但未发生CRBSI的254例住院患者为对照组。收集两组患者的一般情况、基础疾病、营养状况、治疗方式等资料,应用SAS 9.4软件进行单因素和多因素条件logistic回归分析。结果 381例患者中男性261例(68.50%),女性120例(31.50%)。革兰阳性菌是NCC相关CRBSI的主要病原菌。患者身体质量指数(BMI)、文化程度、合并心血管疾病、合并糖尿病、既往终末期肾病治疗史、置管前住院日数和血液透析期间输血治疗是采用NCC执行血液透析患者发生CRBSI的潜在危险因素;多因素条件logistic分析显示,患者高BMI (OR=1.103,95%CI:1.036~1.175)、合并心血管疾病(OR=1.810,95%CI:1.073~3.054)、既往终末期肾病治疗史(OR=1.737,95%CI:1.047~2.884)、置管前住院日数(OR=1.065,95%CI:1.018~1.113)和血液透析期间输血(OR=2.866,95%CI:1.611~5.100)均增加NCC执行血液透析患者发生CRBSI的风险。结论 控制患者体重、加强高风险患者筛查、合理选择血液透析时机、规范血液透析操作技术可有效降低NCC血液透析患者CRBSI发生风险。

    Abstract:

    Objective To explore the risk factors for bloodstream infection related to non-cuffed catheter (NCC) of hemodialysis, and provide basis for the prevention and control of catheter-related bloodstream infection (CRBSI) in hemodialysis patients. Methods A total of 127 hospitalized patients who underwent NCC hemodialysis and developed CRBSI in the department of nephrology of a hospital from January 2015 to December 2024 were selected as the case group. According to a matching ratio of 1∶2, and with gender, renal failure type, and NCC catheterization time ±30 days as matching conditions, 254 hospitalized patients who underwent NCC hemodialysis but did not develop CRBSI were selected as the control group. Data on general information, underlying diseases, nutritional status, treatment methods of two groups of patients were collected. Univariate and multivariate conditional logistic regression analyses were conducted using SAS 9.4 software. Results Among 381 patients, 261 (68.50%) were male and 120 (31.50%) were female. Gram-positive bacteria were the main pathogens of NCC-related CRBSI. Patients’ body mass index (BMI), education level, combined cardiovascular disease, combined diabetes, treatment history of end-stage renal disease, length of hospital stay before catheterization, and blood transfusion therapy during hemodialysis period were potential risk factors for CRBSI in NCC hemodialysis patients. Multivariate conditional logistic analysis showed that patients’ high BMI (OR=1.103, 95% CI: 1.036-1.175), combined cardiovascular disease (OR=1.810, 95% CI: 1.073-3.054), previous treatment history for end-stage renal disease (OR=1.737, 95% CI: 1.047-2.884), length of hospital stay before catheterization (OR=1.065, 95% CI: 1.018-1.113), and blood transfusion during hemodialysis (OR=2.866, 95% CI: 1.611-5.100) all increased the risk of developing CRBSI in NCC hemodialysis patients. Conclusion Controlling patients’ weight, strengthening screening of high-risk patients, selecting appropriate timing for hemodialysis, and standardizing hemodialysis techniques can effectively reduce the risk of CRBSI in NCC hemodialysis patients.

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张鸿,罗业涛,何文昌,等.无隧道和涤纶套的透析导管相关血流感染危险因素病例对照研究[J]. 中国感染控制杂志,2026,25(2):296-302. DOI:10.12138/j. issn.1671-9638.20262536.
ZHANG Hong, LUO Yetao, HE Wenchang, et al. Risk factors for bloodstream infection related to non-cuffed catheter of hemodialysis: a case-control study[J]. Chin J Infect Control, 2026,25(2):296-302. DOI:10.12138/j. issn.1671-9638.20262536.

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  • 收稿日期:2025-05-26
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  • 在线发布日期: 2026-03-04
  • 出版日期: 2026-02-28