老年恶性肿瘤化疗患者PICC血流感染与患者预后的相关性研究  

Correlation between PICC-related bloodstream infection and prognosis in elderly patients receiving chemotherapy for malignancies

作　　者：石春妮 袁丽[1] 罗艳[1] 张柳花[1] 钱金平[2] Shi Chunni;Yuan Li;Luo Yan;Zhang Liuhua;Qian Jinping(PICC Outpatient Service,Tumor Hospital of Nantong City,Nantong,Jiangsu,226321,P.R.China;Department of Medical Oncology,Tumor Hospital of Nantong City,Nantong,Jiangsu,226321,P.R.China)

机构地区：[1]南通市肿瘤医院PICC门诊,江苏南通226321 [2]南通市肿瘤医院肿瘤内科,江苏南通226321

出　　处：《老年医学与保健》2022年第1期115-119,共5页Geriatrics & Health Care

基　　金：南通市科技项目(MSZ21089)。

摘　　要：目的探讨老年恶性肿瘤患者外周中心静脉置管术(PICC)血流感染与患者预后的相关性。方法回顾性纳入2017年1月—2019年1月于南通市肿瘤医院收治的272例PICC置化疗的恶性肿瘤患者为研究对象,并将患者分为PICC相关性血流感染组(n=35)和无PICC相关性血流感染组(n=237)。随访患者的整体生存期,并分析其与PICC相关性血流感染的关系。结果与无PICC相关性血流感染组相比,PICC相关性血流感染组的糖尿病比例和PICC留置时间> 30d比例更高、化疗周期更多、白细胞计数更低、PICC导管自我维护意识更弱(均P<0.05)。糖尿病、PICC留置时间> 30d、化疗周期、白细胞计数和PICC导管自我维护意识弱均是患者PICC导管相关性感染的危险因素。PICC导管相关性血流感染组的中位生存期显著低于无PICC导管相关性血流感染组(25个月vs33个月,P<0.001)。多因素Cox回归分析发现,患者TNM分期和存在PICC导管相关性血流感染(HR=1.49)是影响患者全因死亡的独立危险因素。结论 PICC相关性血流感染能够显著降低患者的生存率,因而,有针对性地降低PICC导管血流感染可能有助于改善患者的预后。To explore the correlation between peripherally-inserted central catheter(PICC)-related bloodstream infection and the prognosis in elderly patients receiving chemotherapy for malignancies. Methods 272 patients with malignant tumors treated with PICC chemotherapy in Tumor Hospital of Nantong City from January2017 to January2019 were included retrospectively. They were divided into PICC-related bloodstream infection group(n= 35)and non-PICC-related bloodstream infection group(n= 237). The overall survival time of the patients was followed up,and its relationship with PICC-related bloodstream infection was analyzed. Results Compared with the non-PICC-related bloodstream infection group,the PICC-related bloodstream infection group had higher proportion of diabetes mellitus and PICC indwelling time>30 d,more chemotherapy cycles,lower white blood cell count,and weaker awareness of PICC catheter self-maintenance(all P< 0.05). Diabetes mellitus,PICC indwelling time> 30 d,chemotherapy cycle,white blood cell count and weak PICC self-maintenance awareness were risk factors for PICC-related bloodstream infection. The median survival time of the PICCrelated bloodstream infection group was significantly shorter than that of the non-PICC-related bloodstream infection group(25 months vs33 months,P< 0.001). Multivariate Cox regression analysis showed that TNM stage and PICC-related bloodstream infection(HR= 1.49)were independent risk factors for all-cause death. Conclusion PICC-related bloodstream infection can significantly reduce the survival rate of patients. Therefore,targeted reduction of PICC-related bloodstream infection may help improve the prognosis of patients.

关 键 词：老年 恶性肿瘤 外周中心静脉置管术 血流感染 预后 

分 类 号：R730.53[医药卫生—肿瘤]