胃肠疾病术后PICC感染与堵塞的相关性研究

The analysis of correlation between picc infection and obstruction

目的本研究旨在探讨胃肠疾病术后中心静脉置管(peripherally inserted central catheter,PICC)的患者导管相关性感染(catheter related blood stream infection,CRBSI)与导管堵塞的相关性,分析导致CRBSI的易感菌株分布状况。方法随机抽取2010年1月-2011年6月锦州市中心医院普外科因胃肠道疾病术后留置PICC并符合纳入标准的210例患者为研究对象。观察其PICC留置期导管堵塞发生率,并对愈后PICC末端进行常规细菌培养,留置时间为(10±4)d,观察CRBSI与PICC堵塞及易感菌株分布状况。运用SPSS13.0软件建立数据库,进行统计学分析。用计数资料分析方法中的χ2检验及列联系数的方法对CRBSI与PICC堵塞发生情况进行相关性分析,对比分析不同性别、年龄、糖尿病及恶性肿瘤患者的堵塞与感染的差异。以P<0.05作为判定差异有统计学意义的标准。结果 210例患者中CRBSI伴有PICC堵塞的为20例,占9.52%;CRBSI未伴有PICC堵塞的为8例,占3.81%;未发生CRBSI发生PICC堵塞的为11例,占5.24%;未发生CRBSI及PICC堵塞的171例,占81.43%。应用χ2检验及列联系数方法分析CRBSI与PICC堵塞的相关性(P<0.05),具有统计学意义;而性别、年龄、是否恶性肿瘤与是否糖尿病对CRBSI和PICC堵塞的差异无统计学意义(P>0.05)。结论本研究所抽取的研究对象中,CRBSI及PICC堵塞与患者年龄、性别、是否患糖尿病及恶性肿瘤无相关性,而CRBSI与PICC堵塞二者之间存在显著的相关性。因此,在临床护理工作中要将CRBSI和PICC堵塞综合考虑,联合预防CRBSI和PICC堵塞是减少PICC并发症的有效方法。

【Objective】Our study was to describe the relationship between PICC-CRBSI and obstruction of the postoperative gastrointestinal cases and to show the distribution of susceptible strains,which provided clinical basis and reference to reduce the PICC complications.【Methods】210 cases were randomLy chosen up to the standard among the postoperative gastrointestinal patients with PICC from JinZhou Central Hospital general surgical wards.The PICC obstruction was observed and the infection was showed through PICC end bacterial culture after treatment（10±4）days as well as the distribution of susceptible strains.The data base was made by SPSS13.0 software.Through comparison analysis,χ2-test and coefficient of contingency were used to show the correlation and the difference of infection and obstruction with different sex,age,with or without diabetes and cancer.The statistical significance was confirmed with P＆lt;0.05.【Resluts】Among our 210 cases,the incidence of CRBSI with obstruction was 20,constituted 9.52 percent;that of CRBSI without obstruction was 8,constituted 3.81 percent;that of obstruction without CRBSI was 11,constituted 5.24 percent;that of cases without both was 171,constituted 81.43 percent.The significant relationship between PICC-CRBSI and obstruction was confirmed through χ2-test（P＆lt;0.05）,while no statistical difference of infection rate and obstruction rate was showed with different sex,age,with or without diabetes and cancer（P＆gt;0.05）.【Conclusion】In our study,PICC infection and obstruction were indifferent of sex,age,with or without diabetes and cancer,but the relationship between PICC-CRBSI and obstruction was significantly confirmed.So both PICC infection and obstruction should be comprehensively considered in clinical nursing procedures.Combination of methods preventing infection and obstruction wound be an effective method to reduce PICC complications.So,serious operating procedures in clinical nursing should be observed and the antibiotics directed against Gram positive bacteria should be priorly chosen.