急性白血病患儿留置中心静脉导管感染的因素分析与控制研究  

Risk factors for peripherally inserted central catheter-associated infections in children with acute leukemia and control strategies

作　　者：陈芳[1] 王小梅[1] 周丽[1] 廖锋[1] 

机构地区：[1]海南省人民医院儿科,海南海口570311

出　　处：《中华医院感染学杂志》2015年第13期3094-3095,3104,共3页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(30843);海南省卫计委医药卫生科研基金项目(14A200047)

摘　　要：目的探讨急性白血病患儿外周留置中心静脉导管感染的因素分析以及控制对策,以降低静脉导管感染率。方法选取急性白血病行外周静脉置入中心静脉导管(PICC)患儿115例,收集其临床资料,采用单因素分析急性白血病患儿外周留置中心静脉导管感染的因素,采用logistic多因素分析导管感染的主要因素,探讨其护理对策。结果 115例患儿发生外周静脉置入中心静脉导管感染28例,发生率为24.35%,单因素分析表明,PICC留置感染的原因包括患儿年龄、穿刺部位渗血、中心静脉导管阻塞、静脉血栓、静脉炎、导管脱出、疾病类型与合并骨性疼痛、PICC穿刺次数及留置时间,其中穿刺部位渗血、中心静脉导管阻塞、导管脱出和PICC穿刺次数是中心静脉导管感染的主要因素。结论提高临床PICC操作质量及合理使用抗菌药物,有利于降低PICC感染的发生。OBJECTIVE To explore the risk factors for the peripherally inserted central catheter （PICC）‐associated infections in the children with acute leukemia and put forward the control strategies so as to reduce the incidence of the venous catheter‐associated infections .METHODS A total of 115 children with acute leukemia who underwent the PICC indwelling were enrolled in the study ,the clinical data of the participants were collected ,the univariate analysis was performed for the risk factors for the PICC‐associated infections ,the logistic regression analysis was carried out for the major risk factors for the catheter‐associated infections ,and the nursing countermeasures were put forward .RESULTS The PICC‐associated infections occurred in 28 of 115 children ,with the incidence rate of 24 .35% .The univariate analysis indicated that the causes of the PICC‐associated infections included the age , puncture site bleeding ,central venous catheter occlusion ,venous thrombosis ,phlebitis ,catheter prolapse ,types of disease ,complication of bone pain ,number of PICC puncture ,and indwelling time;the puncture site bleeding , central venous catheter occlusion ,catheter prolapse ,and number of PICC puncture were the leading causes of the central venous catheter‐associated infections .CONCLUSION It is an effective way to improve the operation quality of clinical PICC and reasonably use antibiotics so as to reduce the incidence of the PICC‐associated infections .

关 键 词：急性白血病 外周静脉置入中心静脉导管 感染 护理 

分 类 号：R181.32[医药卫生—流行病学]