恶性肿瘤患者外周中心静脉导管置管期感染相关因素及血清炎症因子变化的研究  

Infection related factors and changes of serum inflammatory factors of catheterization period in peripheral central venous catheters for patients with malignant tumor

作　　者：王明芳[1] 张文剑[1] 冷丽云[1] 许继映[1] 王瑞利 

机构地区：[1]潍坊市益都中心医院肿瘤科,山东潍坊262500

出　　处：《中华医院感染学杂志》2017年第19期4378-4381,共4页Chinese Journal of Nosocomiology

摘　　要：目的了解恶性肿瘤患者外周中心静脉导管置管期的感染情况、导致患者感染的危险因素及感染对患者血清炎症因子的影响。方法选取医院肿瘤科、心胸外科2015年12月-2016年12月期间收治的外周中心静脉导管置管期恶性肿瘤患者286例为研究对象,对患者置管术后感染发生情况进行分析,对感染患者和非感染患者的相关临床资料进行调查和统计,并采用单因素及多因素回归分析外周中心静脉导管置管期的感染的危险因素,对感染的患者的致病菌进行检测,对感染患者和非感染患者的血清炎症因子水平进行观察。结果 286例患者中感染患者28例,感染率为9.79%;糖尿病、操作人员经验、本次穿刺次数和导管留置时间是外周中心静脉导管置管期感染的独立危险因素;28例感染患者共计检测病原菌55株,其中革兰阴性菌35株占63.64%、革兰阳性菌15株占27.27%、真菌5株占9.09%;感染患者的肿瘤坏死因子(TNF-α)、白细胞介素-12(IL-12)、IL-18、IL-6和IL-8分别为(24.31±7.61)ng/L、(134.51±43.43)ng/L、(253.31±50.32)ng/L、(99.31±38.43)ng/L和(96.31±40.33)ng/L均高于非感染患者的(16.14±6.81)ng/L、(96.31±35.41)ng/L、(185.21±48.31)ng/L、(66.21±32.31)ng/L和(67.21±43.21)ng/L,差异有统计学意义(P<0.05)。结论糖尿病、操作人员经验、本次穿刺次数和导管留置时间是外周中心静脉导管置管期感染的独立危险因素,革兰阴性菌是主要的临床致病菌,感染患者的血清炎症因子水平会显著升高。OBJECTIVE To investigate the infections,risk factors leading to infections,and effect of infections on patients with serum inflammatory factors of catheterization period in peripheral central venous catheters for patients with malignant tumors.METHODS A total of 286 cases with peripheral central venous catheters in patients with malignant tumors during the period from Dec.2015 to Dec.2016 in the department of oncology and cardiothoracic surgery were chosen as the research objects.The incidence of postoperative infections was analyzed,and the related clinical data of infected patients and non-infected patients were taken for investigation and statistics,and univariate analysis and multivariate regression analysis were used to analyze the risk factors of infections in peripheral central venous catheters.The pathogens of the infected patients were tested,and the levels of serum inflammatory cytokines were observed in infected and non-infected patients.RESULTS Totally 28 cases were infected in the 286 patients,and the infection rate was 9.79%.Diabetes mellitus,operator experience,the number of punctures and catheter indwelling time were the independent risk factors for infections of peripheral venous catheter catheterization.Totally 55 pathogens were detected in 28 patients,including 35 strains of gram-negative bacteria,accounting for 63.64%,15 strains of gram-positive bacteria,accounting for 27.27%,and 5strains of fungi,accounting for 9.09%.The tumor necrosis factor（TNF-α）,interleukin-12（IL-12）,interleukin-18（IL-18）,interleukin-6（IL-6）and interleukin-8（IL-8）in infected patients were（24.31±7.61）ng/L,（134.51±43.43）ng/L,（253.31±50.32）ng/L,（99.31±38.43）ng/L and（96.31±40.33）Ng/L,which were significantly higher than non-infected patients of（16.14±6.81）ng/L,（96.31±35.41）ng/L,（185.21±48.31）ng/L,（66.21±32.31）ng/L and（67.21±43.21）ng/L（P〈0.05）.CONCLUSION Diabetes mellitus,the experience of operators,the number of punctures and catheter indwelling time

关 键 词：恶性肿瘤 外周中心静脉导管 感染 血清炎症因子 

分 类 号：R730.1[医药卫生—肿瘤]