采用血液透析监管表对门诊血液透析患者血管通路感染的干预效果

Intervention effect of hemodialysis supervision form on vascular access-related infection in hemodialysis outpatients

摘要:

目的 探讨血液透析监管表对门诊血液透析患者血管通路感染发病率的影响。 方法 采用前瞻性监测，选取某大型教学医院门诊血透析中心2018年3季度—2019年2季度的2 059例患者作为对照组，2019年3季度—2020年2季度的2 074例患者作为干预组（采用血液透析监管表对患者进行监管），比较干预前后血管通路感染发生情况。 结果 干预前血管穿刺部位总感染发病率为1.51%（31例），干预后血管穿刺部位总感染发病率为0.82%（17例），两组比较差异有统计学意义（P < 0.05）。非隧道式颈内静脉置管患者，干预前有1例患者发生血管通路相关血流感染，血管穿刺部位感染率从干预前的7.69%降至干预后的0；非隧道式颈内静脉置管患者在干预后血管穿刺部位感染发病率明显下降，从2018年3季度的10.53%降至0。 结论 采用血液透析监管表对门诊血液透析患者进行干预，可减少血管通路感染的发生。

Abstract:

Objective To investigate the effect of hemodialysis supervision form on incidence of vascular access-related infection(VAI) in hemodialysis outpatients. Methods A prospective monitoring study was conducted, 2 059 patients in the outpatient hemodialysis center of a large teaching hospital from the third quarter of 2018 to the second quarter of 2019 were selected as control group, and 2 074 patients from the third quarter of 2019 to the second quarter of 2020 were selected as intervention group (patients were monitored by hemodialysis supervision form), incidence of VAI before and after intervention was compared. Results The total incidence of infection at puncture sites before and after intervention were 1.51%(n=31) and 0.82% (n=17) respectively, difference between two groups was statistically significant (P < 0.05). For patients with non-tunnelled internal jugular vein catheterization, 1 patient had vascular access-related bloodstream infection, incidence of infection at puncture sites decreased from 7.69% before intervention to 0 after intervention; incidence of infection at puncture sites decreased obviously in patients with non-tunnelled internal jugular vein catheterization, which decreased from 10.53% in the third quarter of 2018 to 0. Conclusion Incidence of VAI can be reduced by the intervention in hemodialysis outpatients with hemodialysis supervision form.