肺癌患者超声引导下PICC置管影响因素的Logistic回归分析  

Logistic regression analysis of factors leading to unplanned extinction with ultrasound-guided PICC after catheterization

作　　者：苑蕾[1] 杜丽娜[1] 杨铭 刘闫[1] 王星力[1] YUAN Lei;DU Li-na;YANG Ming;LIU Yan;WANG Xing-li(Department of Second Oncology Division,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150000,China)

机构地区：[1]哈尔滨医科大学附属第二医院肿瘤二科,黑龙江哈尔滨150000 [2]哈尔滨医科大学附属第一医院康复中心,黑龙江哈尔滨150000

出　　处：《临床肺科杂志》2018年第10期1861-1865,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的对肺癌患者超声引导下PICC置管后非计划拔管影响因素的Logistic回归分析,探讨相关危险因素。方法选取我院需行PICC置管的肺癌患者84例为研究对象,不成功组21例,为非计划拔管患者,成功组63例,未出现非计划拔管,两组患者均采用超声引导下PICC置管,对两组患者的基本资料和住院资料进行赋值后进行Logistic回归分析,分析非计划拔管的危险因素。结果共计84例患者,均成功置管,成功率为100%。对两组患者置管影响因素进行Logistic回归分析,在因素伴发疾病(>1种)方面比较(χ~2=3.910,P=0.048)、治疗方法(手术联合化疗)(χ~2=4.973,P=0.026)、治疗方法(放化疗结合)(χ~2=4.507,P=0.034)、置管类型(χ~2=7.756,P=0.005)、置管静脉选择(肘正中静脉)(χ~2=5.325,P=0.021)、置管静脉选择(头静脉)(χ~2=4.895,P=0.027)、制动时间(χ~2=9.724,P=0.002)、总留置时间(1-4周)(χ~2=27.177,P=0.000)、总留置时间(4-12周)(χ~2=4.675,P=0.031)、总留置时间(12周以上)(χ~2=8.671,P=0.003)、带管住院次数(2-3次)(χ~2=18.599,P=0.000)、带管住院次数(3次以上)(χ~2=12.392,P=0.000)、患者状态(χ~2=10.934,P=0.001),比较中,均具有统计学意义(P<0.05)。结论超声引导下对肺癌患者进行PICC置管,具有极高的置管成功率;同时,患者的伴发疾病,置管类型,置管静脉选择,制动时间,总留置时间,带管住院次数,患者精神状态等因素是造成非计划拔管的危险因素,在PICC置管中,要进行综合考虑。Objective To investigate the unplanned extinction factor with ultrasound-guided PICC after catheterization.Methods 84 patients with PICC catheterization were taken as the study subjects,and there were 21 cases for unplanned extubation patients in the unsuccessful group and 63 cases for no unplanned extubation in the successful group.All the patients underwent ultrasound guided PICC catheterization.It used logistic regression analysis to analyze the basic data and hospitalization and the risk factors for unplanned extubation.Results A total of 84 patients were successfully managed,and the success rate was 100%.Logistic regression analysis was performed on the influencing factors of catheterization in both groups,and there was statistical significance in the correlation as following： the factors associated with disease（ 1 species）（ χ~2= 3.910,P = 0.048）,treatment（ surgery combined with chemotherapy）（ χ~2= 4.973,P = 0.026）,treatment（ radiotherapy and chemotherapy combined）（ χ~2=4.507,P = 0.034）,catheter type（ χ~2= 7.756,P = 0.005）,intravenous catheter selection（ elbow median vein）（χ~2= 5.325,P = 0.021）,venous catheter selection（ head vein）（ χ~2= 4.895,P = 0.027）,total retention time（1-4 weeks）（χ~2 = 9.724,P = 0.002）,total retention time（4-12 weeks）（χ~2= 27.177,P = 0.000）,total retention time（12 weeks or more）（ χ~2= 8.671,P = 0.003）,hospitalization with tube（2-3 times）（ χ~2= 18.599,P = 0.000）,hospitalization with tube（ more than 3 times）（ χ~2= 12.392,P = 0.000）,patient status（ χ~2=10.934,P = 0.001）.Conclusion There is a very high catheter success rate with ultrasound-guided patients with PICC catheterization,and the unplanned extubation risk factors are as follows： the patient＇s associated disease,catheter type,catheter intravenous selection,braking time,total retention time,tube hospitalization,and mental status,which needs to be considered in the PICC catheterization.

关 键 词：PICC置管 非计划拔管 基本资料 住院资料 回归分析 

分 类 号：R473.73[医药卫生—护理学]