Risk Factors and Nursing Strategies of PICC Catheter-related Infection in Tumor Patients
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摘要:
目的 分析肿瘤患者PICC导管相关性感染的危险因素及对策。 方法 纳入2019年5月至2020年8月，在昆明医科大学第二附属医院肿瘤科接受治疗的PICC置管18岁以上肿瘤患者180例。依据患者是否出现PICC导管相关性感染，将其分为非感染组162例与感染组27例。对比两组在性别、年龄、单次置管穿刺数、PICC保留时间、导管移动、化疗次数、合并糖尿病等差异。 结果 对比感染组和未感染组在年龄、性别方面无显著差异（P > 0.05），单次置管穿刺数、PICC保留时长、导管移动、化疗次数、糖尿病等方面有显著差异，对比两组有统计学意义（P < 0.05）；导管移动（OR = 2.421）、化疗次数（OR = 6.475）、合并糖尿病（OR = 3.271）等基础疾病为CRI危险因素。 结论 肿瘤患者PICC置管术后出现导管相关性感染的危险因素有很多，主要是导管发生移动、化疗频率及糖尿病等，在临床上针对相关危险因素实对症护理策略，能够最大程度地防止及降低导管相关性感染几率。 Abstract:Objective To analyze the risk factors and countermeasures of PICC catheter-related infection in cancer patients. Methods From May 2019 to August 2020, 180 patients over 18 years old with PICC were enrolled and divided into non infection group（162 cases）and infection group（18 cases）. The differences in gender, age, single catheterization puncture number, PICC retention time, catheter movement, chemotherapy times and diabetes mellitus were compared between the two groups. Results There were no significant differences in age and gender between the infection group and non infection group（P > 0.05）, but there were significant differences in single catheterization puncture number, PICC retention time, catheter movement, chemotherapy times and diabetes mellitus between the two groups（P < 0.05）; the basic diseases such as catheter movement（or = 2.421）, chemotherapy times（or = 6.475）, and diabetes mellitus（or = 3.271）were CR I risk factors. Conclusion There are many risk factors for catheter-related infection in cancer patients after PICC catheterization, mainly including catheter movement, chemotherapy frequency and diabetes mellitus. In clinical practice, symptomatic nursing strategies for related risk factors can prevent and reduce the probability of catheter-related infection to the greatest extent. -
Key words:
- Tumor patients /
- PICC catheter /
- Related infection /
- Risk factors /
- Nursing countermeasures
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表 1 分析PICC 导管相关性感染的危险原因单因素（n，%）
Table 1. To analyze the risk factors of PICC catheter-related infection （n，%）
项目 感染组（n = 27） 未感染组（n = 153） χ2 P 年龄（岁） 0.337 > 0.05 < 60 12（44.44） 65（42.48） ≥60 15（55.56） 88（57.52） 性别 0.621 > 0.05 男 14（51.85） 80（52.29） 女 13（48.15） 73（47.71） 单次置管穿刺次数（次） 32.656 < 0.01 1 5（18.52） 115（75.16） 2及以上 22（81.48） 38（24.84） PICC留置时间（d） 23.197 < 0.01 < 60 9（33.33） 91（59.48） ≥60 18（66.67） 62（40.52） 导管移动 11.845 < 0.01 无 7（25.93） 101（66.01） 有 20（74.07） 52（33.99） 化疗次数（次） 16.393 < 0.01 < 5 9（33.33） 49（32.03） ≥5 18（66.68） 104（67.97） 糖尿病 11.346 < 0.01 无 10（37.04） 97（63.40） 有 17（62.96） 56（36.6） 
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表 2 导管相关性感染危险因素的多因素分析
Table 2. Objective to analyze the risk factors of catheter-related infection
变量 SE β Waldχ2 P OR 95%CI 有导管移动 6.231 0.841 11.784 < 0.05 2.421 1.556～3.516 化疗次数≥5 7.486 0.537 16.453 < 0.05 6.475 1.243～2.294 合并糖尿病 5.473 0.639 11.464 < 0.05 3.271 1.196～3.753
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