老年肿瘤患者PICC导管相关性感染危险因素及病原菌分析  

Risk factors and the pathogenic bacteria of PICC-related infections in elderly tumor patients

作　　者：刘冰艳[1] 赵菊红[1] 苏宝艳[1] 史宏刚[2] 

机构地区：[1]中国人民解放军第3医院中医肿瘤科,陕西宝鸡721004 [2]中国人民解放军第254医院肿瘤科

出　　处：《护理学杂志》2015年第13期87-89,96,共4页

摘　　要：目的分析老年肿瘤化疗患者PICC导管相关性感染的感染病原菌分布及其危险因素,为临床工作中有效防治导管相关性感染提供参考。方法收集2013年1月至2014年12月行PICC置管的老年肿瘤化疗患者246例,分析PICC导管相关性感染的病原菌分布,对PICC导管相关性感染的危险因素进行分析。结果 246例老年肿瘤化疗患者中发生PICC导管相关性感染为28例,发生率为11.4%。病原菌分布为革兰阳性菌(55.9%),革兰阴性菌(26.5%)和真菌(17.6%)。单次穿刺次数、PICC留置时间、输液类型、使用激素、白细胞计数、糖尿病史及静脉炎史是导管相关性感染发生率的影响因素(P<0.05,P<0.01)。结论老年肿瘤化疗患者是导管相关性感染的高发人群。应采取PICC置管前充分评估,严格执行PICC置管无菌操作,规范PICC日常维护,加强患者免疫机能等措施,减少老年肿瘤化疗患者PICC导管相关性感染的发生。Objective To explore the risk factors and the pathogenic bacteria of peripherally inserted central catheter （PICC）-related infections in elderly tumor patients. Methods A total of 246 elderly tumor patients carrying a PICC line for chemotherapy were en- rolled. The bacteriologic culture of blood and catheter tip was performed, and the spectrum of pathogenic bacteria for catheter-re- lated infections was analyzed. Results The incidence of catheter-related infections was 11.4 %. The pathogens included gram positive bacteria （55.9%）, gram negative bacteria （26.5 %） and fungi （17.6%）. Catheter-related infection was related with such factors as number of single puncture, PICC indwelling duration, infusion types, hormone therapy, white blood cell count, as well as dia- betes and phlebitis history （P〈0.05 ,P〈0.01）. Conclusion Elderly tumor patients undergoing chemotherapy were high risk popu lation of PICC-related infections. To prevent such infections, the risk factors should be evaluated sufficiently before PICC placement and strict aseptic operation should be conducted during PICC placement, in addition to strengthening patients＇ immune function.

关 键 词：经外周静脉置入中心静脉导管 导管相关性感染 老年肿瘤患者 影响因素 

分 类 号：R472[医药卫生—护理学]