血液肿瘤患者PICC导管相关感染及危险因素分析

Analysis of PICC Catheter-related Infection and Risk Factors in Patients with Hematological Tumors

目的探讨血液肿瘤患者经外周静脉置入中心静脉导管(PICC)相关感染特点及其危险因素。方法选取3643例行PICC置管的血液肿瘤患者,分析PICC导管相关感染发生率及其病原菌分布,采用多因素logistic回归分析筛选导管相关感染的危险因素。结果血液肿瘤患者PICC导管相关感染率为4.17%(152/3643);多因素分析结果显示,影响PICC导管相关感染的危险因素包括穿刺次数(OR=3.337)、导管留置时间(OR=4.884)、导管移动(OR=2.710)、机体免疫功能低下(OR=4.367)、广谱抗生素使用时间(OR=3.124)及换药时间(OR=3.490)等。结论PICC导管相关感染是多种因素相互作用的结果,应早期、全面、动态评估危险因素,采取预防措施,降低导管相关感染发生率。

Objective To explore the characteristics and risk factors of infection related to peripherally inserted central catheter(PICC)in patients with hematological tumors.Methods 3643 patients with hematological tumors who underwent PICC catheterization were selected to analyze the incidence of PICC catheter-related infection and the distribution of pathogenic bacteria.Multivariate logistic regression method was used to screen the risk factors of catheter-related infection.Results The PICC catheter-related infection rate of patients with hematological tumors was 4.17%(152/3643).The results of multivariate analysis showed that the risk factors affecting PICC catheter-related infection included the number of punctures(OR=3.337),catheter indwelling time(OR=4.884),catheter movement(OR=2.710),low immune function(OR=4.367),time of broad-spectrum antibiotic use(OR=3.124)and time of dressing change(OR=3.490),etc.Conclusion PICC catheter-related infection is the result of the interaction of multiple factors.Risk factors should be assessed early,comprehensively and dynamically,and preventive measures should be taken to reduce the incidence of catheter-related infection.