乳腺癌化疗患者长期深静脉置管发生导管相关感染影响因素的Meta分析  

Meta analysis of the infl uencing factors of catheter related infection after long-term deep vein catheterization in breast cancer chemotherapy

作　　者：黄娅黎 蒙祖谋 吴彦仪[1] HUANG Yali;MENG Zumou;WU Yanyi(Affiliated Hospital of Guilin Medical University,Guilin,541000,China)

机构地区：[1]桂林医学院附属医院,广西壮族自治区桂林市541000 [2]广西中医药大学研究生院

出　　处：《护理实践与研究》2023年第18期2746-2752,共7页Nursing Practice and Research

摘　　要：目的系统评价乳腺癌化疗长期深静脉置管患者发生导管相关感染的影响因素。方法检索中国生物医学文献服务系统(CBM)、中国知网(CNKI)、万方数据库、维普期刊数据库、PubMed、Embase、Cochrane、Web of Science等中英文数据库,对建库至2022年9月关于乳腺癌化疗长期深静脉置管发生导管相关感染影响因素的病例对照研究进行Meta分析。结果共纳入14篇文献,其中包含5090例接受长期深静脉置管的乳腺癌化疗患者,合并导管相关感染765例,发生率为15.03%。Meta分析结果显示:导管留置时间(PICC组)(OR=3.10,95%CI:1.95~4.94,P=0.000)、导管留置时间(TIVAP组)(OR=4.09,95%CI:1.98~8.44,P=0.000)、合并基础病(OR=4.68,95%CI:2.51~8.73,P=0.000)、化疗次数(OR=4.73,95%CI:3.15~7.08,P=0.000)、合并糖尿病(OR=3.55,95%CI:2.41~5.21,P=0.000)、导管维护周期(OR=2.15,95%CI:1.99~2.46,P=0.000)、导管移动(OR=6.421,95%CI:4.02~10.26,P=0.000)、年龄(OR=6.30,95%CI:4.81~8.26,P=0.000)、白细胞计数(OR=5.98,95%CI:4.97~7.25,P=0.000)、换敷贴天数(OR=4.28,95%CI:3.16~5.80,P=0.000)、肠外营养(OR=3.96,95%CI:2.68~5.84,P=0.000)为乳腺癌化疗长期深静脉置管发生导管相关感染的影响因素。结论导管留置时间、合并基础病、化疗次数、合并糖尿病、导管维护周期、导管移动、年龄、白细胞计数、换敷贴天数、肠外营养是乳腺癌化疗长期深静脉置管发生导管相关感染的影响因素,针对上述影响因素制订预防管理措施可以降低感染的发生率,改善患者预后。Objective To systematically evaluate the infl uencing factors of catheter-related infection in patients with breast cancer undergoing long-term chemotherapy and deep vein catheterization.Methods The China Biomedical Literature Service Database(CBM),China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Data,PubMed,Embase,Cochrane,Web of Science and other major Chinese and English databases were searched,and the case-control study on the infl uencing factors of catheter related infection caused by long-term deep vein catheterization in breast cancer chemotherapy from the establishment of the database to September 2022 was analyzed by meta-analysis.Results A total of 14 articles were included,including 5090 breast cancer patients receiving long-term deep vein catheterization chemotherapy,765 patients with catheter related infection,the incidence rate was 15.03%.The Meta-analysis results showed that the catheter indwelling time(PICC group)(OR=3.10,95%CI:1.95~4.94,P=0.000),catheter indwelling time(TIVAP group)(OR=4.09,95%CI:1.98~8.44,P=0.000),combined basic diseases(OR=4.68,95%CI:2.51~8.73,P=0.000),chemotherapy frequency(OR=4.73,95%CI:3.15~7.08,P=0.000),combined diabetes(OR=3.55,95%CI:2.41~5.21,P=0.000),catheter maintenance cycle(OR=2.15,95%CI:1.99~2.46,P=0.000),catheter movement(OR=6.421,95%CI:4.02~10.26,P=0.000),age(OR=6.30,95%CI:4.81~8.26,P=0.000),white blood cell count(OR=5.98,95%CI:4.97~7.25,P=0.000),days of dressing change(OR=4.28,95%CI:3.16~5.80,P=0.000),and parenteral nutrition(OR=3.96,95%CI:2.68~5.84,P=0.000)were the infl uencing factors for catheter related infection caused by long-term deep vein catheterization in breast cancer chemotherapy.Conclusion The catheter indwelling time,combined basic diseases,chemotherapy frequency,combined diabetes,catheter maintenance cycle,catheter movement,age,white blood cell count,days of dressing change,and parenteral nutrition were the influencing factors for catheter related infection caused by long-term deep vein catheterization in breast cancer chemotherapy.Fo

关 键 词：导管相关感染 乳腺癌 化疗 深静脉置管 META分析 

分 类 号：R473.73[医药卫生—护理学]