肿瘤患者PICC导管相关血流感染危险因素的logistic回归分析

Logistic regression analysis on risk factors for peripherally inserted central catheter-related bloodstream infection in patients with tumor

目的探讨肿瘤患者经外周静脉穿刺中心静脉置管导管相关血流感染(PICC-CRBSI)的危险因素。方法选取2015年2月—2017年2月荆州市某三级甲等医院中心静脉置管登记数据库中能获取完整资料的PICC患者。将48例确诊为PICC-CRBSI的肿瘤患者作为研究对象,1∶1配对进行病例对照研究,通过条件logistic回归分析,筛选主要危险因素。结果共有PICC置管患者1 357例,纳入698例,发生PICC-CRBSI 48例,发病率为6.88%;PICC总插管日数为13 953 d,每千导管日发病率为3.44‰。穿刺次数≥3次(OR=2.05)、X线胸片定位(OR=4.23)、未按时维护(OR=2.17)是PICC-CRBSI发生的独立危险因素。结论 PICC-CRBSI与穿刺次数、定位方法、维护频率等因素有关,针对PICC置管患者减少穿刺次数、置管过程中采用心电图(EKG)定位、按时维护可减少PICC-CRBSI的发生。

Objective To explore risk factors for peripherally inserted central catheterrelated bloodstream infection（PICCCRBSI）in patients with tumor. MethodsPatients with PICC and had accessible complete information from central venous catheter registry database in a tertiary firstclass hospital in Jingzhou City between February 2015 and February 2017 were chosen. 48 tumor patients with PICCCRBSI were performed 1∶1 matched casecontrol study, the main risk factors were screened through logistic regression analysis. ResultsThere were 1 357 patients with PICC, 698 were recruited in the study, 48 cases had PICCCRBSI, incidence was 6.88%; the total PICC days were 13 953 days, incidence was 3.44 per 1 000 catheter days. No.of puncture ≥3（OR=2.05）, positioning of chest Xray （OR=4.23）, and without timely maintenance （OR=2.17） were independent risk factors for PICCCRBSI.ConclusionPICCCRBSI is related to No. of puncture, positioning method and maintenance frequency, the occurrence of PICCCRBSI can be decreased by reducing the No. of puncture, positioning by electrocardiogram （EKG） during catheterization process, and timely maintenance.