耐药性肺癌患者化疗中PICC相关并发症及感染危险因素分析  

Analysis of PICC related complications and infection risk factors in chemotherapy for drug-resistant lung cancer patients

作　　者：郭婷[1] 宋新霞[1] 汤肖肖 张敏[1] GUO Ting;SONG Xin-xia;TANG Xiao-xiao;ZHANG Min(Department of Medical Oncology,Xingtai People's Hospital,Hebei,Xingtai 054031,China)

机构地区：[1]邢台市人民医院肿瘤内一科,河北邢台054031

出　　处：《中国医学前沿杂志（电子版）》2019年第4期62-65,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：河北省卫生厅重点科技研究计划项目(2015038)

摘　　要：目的探讨耐药性肺癌患者化疗中经外周静脉置入中心静脉导管(peripherally inserted central venous catheter,PICC相关并发症及感染危险因素。方法选取本院2014年1月至2018年1月收治的耐药性肺癌患者273例,探讨其化疗中PICC并发症发生情况。分离并鉴定PICC感染病原菌,分析影响PICC感染的独立危险因素。结果 273例患者中,并发症发生率为23.08%,其中感染发生率最高(10.62%)。感染患者29例,共分离培养出病原菌37株,其中革兰阳性菌23株,革兰阴性菌14株。单因素分析显示,年龄、TNM分期、合并糖尿病、PICC留置时间及预防性使用抗菌药物均与PICC感染有关(P_均<0.05)。经多因素Logistic回归分析显示,年龄≥50岁、合并糖尿病、PICC留置时间≥30 d及预防性使用抗菌药物均为耐药性肺癌患者化疗中PICC感染的独立危险因素(P_均<0.05)。结论耐药性肺癌患者化疗中PICC相关并发症发生率较高,以感染最为常见,感染病原菌以革兰阳性菌为主,其中年龄、合并糖尿病、PICC留置时间及预防性使用抗菌药物均为PICC感染的独立危险因素。Objective To investigate the complications and infection risk factors of peripherally inserted central venous catheter(PICC)in patients with drug-resistant lung cancer.Method 273 patients with drug-resistant lung cancer admitted to our hospital from January 2014 to January 2018 were enrolled to investigate the occurrence of PICC complications.Pathogenic bacteria of PICC infection were isolated and identified,and independent risk factors affecting PICC infection were analyzed.Result Among the 273 patients,the complication rate was 23.08%,among which the infection rate was the highest(10.62%).Infected 29 patients,37 strains of pathogens were isolated,included 23 Gram-positive bacteria and 14 Gram-negative bacteria.Univariate analysis showed that age,TNM stage,combined with diabetes mellitus,duration of PICC indwelling,and prophylactic use of antibiotics were associated with PICC infection(Pall<0.05).Multivariate Logistic regression analysis showed that,age ≥ 50 years old,combinedwith diabetes mellitus,PICC catheterization time ≥ 30 d,and prophylactic use of antibiotics were independent risk factors for PICC infection in patients with drug-resistant lung cancer(Pall<0.05).Conclusion The incidence of PICC-related complications in patients with drug-resistant lung cancer is higher,with infection being the most common.Infectious pathogens are mainly Gram-positive bacteria.Age,combined with diabetes mellitus,PICC catheterization time,and prophylactic use of antibiotics are independent risk factors for PICC infection in patients with drug-resistant lung cancer.

关 键 词：耐药性 肺癌 化疗 经外周静脉置入中心静脉导管 并发症 感染 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]