老年患者经外周静脉置入中心静脉导管置管相关并发症及影响因素研究  

A study on complications of peripherally inserted central catheter catheterization in the elderly and its influencing factors

作　　者：周竞奋 李洁 姜莉丽 滕芳 曹红云 Zhou Jingfen;Li Jie;Jiang Lili;Teng Fang;Cao Hongyun(Department of Hematology,Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu,214000,P.R.China;Department of Infectious Diseases,Fifth People's Hospital of Wuxi City,Wuxi,Jiangsu,214000,P.R.China)

机构地区：[1]江南大学附属医院血液科,江苏无锡214000 [2]无锡市第五人民医院感染科,江苏无锡214000

出　　处：《老年医学与保健》2024年第6期1818-1822,共5页Geriatrics & Health Care

摘　　要：目的探究老年患者经外周静脉置入中心静脉导管(PICC)置管相关并发症及影响因素。方法回顾性分析2023年5月—2024年6月江南大学附属医院收治的80例老年PICC置管患者的临床资料,根据患者是否发生置管相关并发症进行分组,将43例未见置管并发症的患者纳入未发生组,将37例发生置管并发症的患者纳入发生组。使用单因素分析2组的临床资料,使用多因素Logistic回归分析影响置管并发症的独立危险因素。结果发生组中,静脉炎12例(32.43%)、导管相关感染9例(24.32%)、导管位移7例(18.92%)、静脉血栓9例(24.32%)。经单因素分析,2组患者是否合并糖尿病、静脉血栓史、PICC置管史、导管留置时长、穿刺部位、皮肤消毒方式差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,合并糖尿病、静脉血栓史、PICC置管史、导管留置时长、穿刺部位和皮肤消毒方式是影响患者PICC置管并发症的独立危险因素(P<0.05)。结论PICC置管并发症主要受糖尿病、静脉血栓史、PICC置管史、导管留置时长、穿刺部位和皮肤消毒方式影响,临床治疗时需合理选择穿刺部位,调整导管留置时长,做好皮肤消毒工作,以降低置管并发症发生率。Objective To explore the complications of peripherally inserted central catheter(PICC)catheterization in the elderly and its influencing factors.Methods A retrospective analysis was performed on the clinical data of 80 elderly patients undergoing PICC catheterization in Affiliated Hospital of Jiangnan University from May 2023 to June 2024.Patients were grouped according to whether they developed catheterization-related complications.43 patients without catheterization-related complications were included in the non-occurrence group,and 37 ones with catheterization-related complications were included in the occurrence group.Univariate analysis was used to analyze the clinical data of the two groups,and multivariate Logistic regression was used to analyze the independent risk factors for catheterization-related complications.Results In the occurrence group,there were 12 cases(32.43%)with phlebitis,9 ones(24.32%)with catheter-related infection,7 ones(18.92%)with catheter displacement and 9 ones(24.32%)with venous thrombosis.Univariate analysis showed that there were significant differences in diabetes mellitus,history of venous thrombosis,history of PICC catheterization,catheter indwelling time,puncture sites and skin disinfection modes between the two groups(P<0.05).Multivariate logistic regression analysis showed that diabetes mellitus,history of venous thrombosis,history of PICC catheterization,long-term catheter indwelling,puncture site and skin disinfection mode were independent risk factors for PICC catheterization-related complications(P<0.05).Conclusion The main influencing factors for PICC catheterization-related complications include diabetes mellitus,history of venous thrombosis,history of PICC catheterization,long-term catheter indwelling,puncture site and skin disinfection mode.In clinical treatment,it is necessary to rationally select puncture sites,adjust catheter indwelling time and take good skin disinfection to reduce the incidence of catheterization-related complications.

关 键 词：老年 经外周静脉置入中心静脉导管 置管并发症 糖尿病 静脉血栓 影响因素 

分 类 号：R47[医药卫生—护理学]