肿瘤PICC置管处患者继发皮肤损害的菌群耐药性及复方黄柏液涂剂治疗对并发症和炎性反应的影响  

Bacterial Resistance and Effect of Compound Phellodendron Solution on Complications and Inflammatory Response in Secondary Skin Damage of Patients with Tumor PICC Catheterization

作　　者：杨晔 蒋成 YANG Ye;JIANG Cheng(Department of oncology,Hai'an people's Hospital,Hai'an Jiangsu,226600,China)

机构地区：[1]海安市人民医院肿瘤科,江苏海安226600

出　　处：《转化医学杂志》2023年第1期31-34,共4页Translational Medicine Journal

基　　金：南通市科技计划项目(MSZ19124)。

摘　　要：目的研究肿瘤经外周穿刺中心静脉导管置入术(peripherally inserted central catheter,PICC)置管处患者继发皮肤损害的菌群耐药性及复方黄柏液涂剂治疗对导管相关并发症和炎性反应的影响。方法本研究采用回顾性研究,主要以2020年12月至2021年12月海安市人民医院收治的40例PICC置管处继发皮肤损害患者作为研究对象,根据患者治疗手段的差异分为两组,各20例。对照组根据药敏情况采取相应的抗生素治疗,观察组联合采用复方黄柏液涂剂。分析肿瘤患者PICC置管处继发皮肤损害菌群的分布,研究两组患者的导管相关并发症及炎性反应之间的差异。结果PICC置管处继发皮肤损害病原菌感染主要以革兰阳性菌和革兰阴性菌为主,真菌感染较少。凝固酶阴性葡萄球菌、肺炎链球菌、金黄色葡萄球菌主要对青霉素、苯唑西林及氨苄西林耐药。鲍曼不动杆菌、阴沟肠杆菌、大肠埃希菌主要通过对亚胺培南以及阿米卡星耐药。观察组患者发生导管相关血流感染、穿刺口感染、导管移位和脱出、管端细菌定植情况低于对照组(P<0.05)。两组患者经过治疗后,白细胞介素-1β、肿瘤坏死因子-α和白细胞介素-6水平均显著下降,且观察组低于对照组(P<0.05)。结论肿瘤患者PICC置管处继发皮肤损害菌群主要以革兰氏阴性菌为主,对PICC置管处继发皮肤损害患者的治疗中采取复方黄柏液涂剂,患者的治疗效果显著,炎性反应显著下降。Objective To study the bacterial resistance of secondary skin damage in patients with tumor peripherally inserted central catheter(peripherally inserted central catheter,PICC)catheterization site and effect of compound phellodendron solution on catheter-related complications and inflammatory response in treatment of it.Methods This retrospective study enrolled 40 patients with skin damage secondary to PICC catheterization who were admitted from December 2020 to December 2021 as the research object.The patients were divided into observation group and control group according to the difference of treatment methods,with 20 patients in each group.The patients in the control group were treated with corresponding antibiotics according to their drug sensitivity,and the patients in the observation group were treated with compound phellodendron solution.The distribution of bacteria in tumor patients with skin damage secondary to PICC catheterization was analysed,and the differences of catheter related complications and inflammatory response between the two groups of patients with were also studied.Result The pathogens of skin damage was mainly gram positive bacteria and gram negative bacteria,and fungal infection was less.Coagulase negative staphylococcus,Streptococcus pneumonia,and Staphylococcus aureus were mainly resistant to penicillin,benzoxillin,and ampicillin.Acinetobacter baumannii,Enterobacter cloacae,and Escherichia coli were resistant to imipenem and amikacin.The infection of blood flow,the infection of puncture port,the displacement and removal of catheter,and the bacterial colonization of the tube end were significantly lower in the observation group than those in the control group(P value<0.05).After treatment,interleukin-1β,tumor necrosis factor,and interleukin-6 in both groups were significantly decreased,and in the observation group,they were lower than those in the control group(P value<0.05).Conclusion Gram negative bacteria are the main bacteria in the secondary skin damage of tumor patients with PICC.

关 键 词：经外周穿刺中心静脉导管置入术 皮肤损害 复方黄柏液涂剂 耐药性 

分 类 号：R473.73[医药卫生—护理学]