血液肿瘤患者经外周静脉置入中心静脉导管相关性感染的危险因素与预防措施  

Risk factors for peripherally inserted central catheter-related infections in hematologic tumor patients and prevention measures

作　　者：林群[1] 吴达娟[1] 胡桂芳[1] 贾莉[1] 

机构地区：[1]海南省人民医院血液内科,海南海口570311

出　　处：《中华医院感染学杂志》2015年第17期3982-3984,共3页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(30843)

摘　　要：目的探讨血液肿瘤患者经外周静脉置入中心静脉导管(PICC)导管相关性感染的危险因素与护理对策,以降低血液肿瘤患者PICC相关性感染率。方法回顾性分析医院140例经外周静脉置入中心静脉留置导管血液肿瘤患者的临床资料,对PICC感染的相关因素实施单因素及多因素logistic回归分析,并提出护理对策;对PICC导管相关性感染患者的送检标本进行病原学检测。结果 140例PICC血液肿瘤患者中发生PICC导管相关性感染25例,感染率为17.86%;单因素分析结果显示,穿刺次数、合并症、导管留置时间、激素应用史、化疗药物应用、免疫功能、季节等因素与血液肿瘤患者PICC导管相关性感染具有相关性(P<0.05);多因素logistic回归分析结果显示,穿刺次数、穿刺季节和免疫功能是血液肿瘤患者PICC导管相关性感染的独立危险因素;25例PICC相关性感染患者共培养细菌20株,其中金黄色葡萄球菌10株、肺炎克雷伯菌4株、微小棒杆菌2株,其他4株。结论针对血液肿瘤患者PICC导管相关性感染的危险因素和病原菌分布特点,采取相应的预防措施,从而控制和降低感染的发生。OBJECTIVE To explore the risk factors for peripherally inserted central catheter（PICC）-related infections in the hematologic tumor patients and put forward the nursing countermeasures so as to reduce the incidence of PICC-related infections in the hematologic tumor patients.METHODS The clinical data of 140 hematologic tumor patients who were treated with PICC were retrospectively analyzed.The univariate analysis and multivariate logistic regression analysis were performed for the related factors for the PICC-related infections,the nursing countermeasures were put forward,and the etiological examination was carried out for the submitted specimens that were obtained from the patients with PICC-related infections.RESULTS Of the 140 patients with hematologic tumor who were treated with PICC,25 had the PICC-related infections,with the infection rate of 17.86%.The results of the univariate analysis indicated that the incidence of the PICC-related infections in the patients with hematologic tumor was associated with the number of times of puncture,complications,catheter indwelling time,history of use of hormones,use of chemotherapy drugs,immune function,and seasons（P〈0.05）.The results of the multivariate logistic regression analysis showed that the independent risk factors for the PICC-related infections in the patients with hematologic tumor included the number of times of puncture,seasons of puncture,and immune function.A total of 20 strains of bacteria were cultured from the 25 patients with PICC-related infections,including 10 strains of Staphylococcus aureus,4strains of Klebsiella pneumoniae,2strains of Corynebacterium,and 4strains of other species.CONCLUSIONIt is necessary to take targeted prevention measures according to the risk factors for the PICC-related infections in the patients with hematologic tumor and the characteristics of distribution of the pathogens so as to reduce the incidence of the infections.

关 键 词：血液肿瘤 经外周静脉置入中心静脉 导管相关性感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]