乳腺癌患者静脉输液港导管相关血流感染预测模型构建  

Construction of a predictive model for venous access port induced catheter-related bloodstream infection in breast cancer patients

作　　者：贾维慧 孙香莲 厉丹阳 赵姝姝[3] 孙宁鑫 宋艳梅 李洪利 尹崇高[1] Jia Weihui;Sun Xianglian;Li Danyang;Zhao Shushu;Sun Ningxin;Song Yanmei;Li Hongli;Yin Chonggao(School of Nursing,Weifang Medical University.Weifang 261053,China)

机构地区：[1]潍坊医学院护理学院,山东潍坊261053 [2]潍坊医学院第一附属医院乳腺甲状腺外科 [3]潍坊医学院附属医院肿瘤内科 [4]潍坊医学院医学研究实验中心

出　　处：《护理学杂志》2022年第15期56-60,共5页Journal of Nursing Science

基　　金：山东省高等学校青创人才引育计划建设团队项目(205)。

摘　　要：目的构建乳腺癌患者输液港发生中心静脉导管相关血流感染的预测模型,并进行验证。方法收集609例住院患者的临床资料作为建模组,收集261例住院患者的临床资料作为验证组,通过单因素和多因素分析获得患者发生导管相关血流感染的危险因素,据此构建预测模型。结果建模组中83例(13.63%)发生中心静脉导管相关血流感染,感染病原菌以革兰阴性菌为主,占51.75%(59/114)。最终筛选出糖尿病史、各周期化疗平均使用蝶形针时间、静脉输液港留置时间、治疗方案、肠外营养、白蛋白6个因素构建出风险预测模型。预测曲线和观察曲线基本吻合,ROC曲线下面积为0.809。结论糖尿病史、蝶形针各周期化疗平均使用时间及静脉输液港留置时间较长、姑息治疗、合并肠外营养支持、白蛋白<30 g/L是乳腺癌患者输液港发生中心静脉导管相关血流感染的独立危险因素,构建的预测模型具有较好的准确度和区分度,预测效能较好。Objective To construct and validate a predictive model for implantable venous access port(IVAP)induced catheter-related bloodstream infection(CRBSI)in breast cancer patients.Methods Clinical data of 609 and 261 breast cancer inpatients were collected as a modeling group and a validation group,and the risk factors of CRBSI were obtained by univariate and multivariate analysis to construct a predictive model.Results A total of 83(13.63%)patients in the modeling group suffered from CRBSI,and the pathogenic infecting organisms were predominantly gram-negative bacteria,which accounted for 51.75%(59/114).The final risk predictive model consisted of six factors:history of diabetes,the average use time of butterfly needle in each chemotherapy cycle,IVAP retention time,treatment regime,parenteral nutrition support and albumin.The prediction curve and the observation curve basically matched,and the area under the ROC curve was 0.809.Conclusion History of diabetes,the long retention of butterfly needle and IVAP,palliative care,parenteral nutrition support and albumin<30 g/L are independent risk factors of CRBSI in breast cancer patients with IVAP,the predictive model has good accuracy and discrimination,and it displays good predictive performance.

关 键 词：乳腺癌 静脉输液港 中心静脉导管相关血流感染 中心静脉置管 静脉治疗 非计划性拔管 预测模型 

分 类 号：R473.73[医药卫生—护理学]