神经内科患者外周浅静脉留置针相关性静脉炎危险因素的Cox回归模型分析

Cox Regression Model for Risk Factors of catheter-related superficial Peripheral Phlebitis of Patients in Neurological Department

目的应用Cox回归模型分析神经内科患者外周浅静脉留置针相关性静脉炎发生的危险因素。方法收集2015年6—8月南京地区3家三级甲等医院神经内科患者外周浅静脉穿刺留置针相关临床资料,采用Cox回归模型对外周浅静脉留置针静脉炎相关因素进行单因素、多因素分析,建立模型。结果 Cox回归多因素分析显示：高渗透压（HR=7.243,95%CI：4.590~11.429,P〈0.001）、p H〉9（HR=4.683,95%CI：2.274~9.642,P〈0.001）、p H〈5（HR=1.840,95%CI：1.043~3.246,P=0.035）、在肘窝处置管（HR=4.109,95%CI：1.808~9.338,P〈0.001）、每日输注液体总量〉1 500 m L（HR=1.753,95%CI：1.105~2.782,P=0.017）为静脉炎发生的危险因素。建立静脉炎危险因素模型预后指数（PI）为PI=7.243高渗透压药物＋4.683 p H〉9药物＋1.840 p H〈5药物＋4.109在肘窝处置管＋1.753每日输注液体总量〉1 500 m L。PI值越小,静脉炎发生危险性越低;PI值越大,静脉炎发生危险性越高。结论影响神经内科患者静脉炎发生的危险因素为高渗透压（〉600 m Osm/L）、p H〉9、p H〈5、肘窝处置管、每日液体总量〉1 500 m L,并建立回归模型,为正确实施预防静脉炎措施提供参考。

Objective To analyze the risk factors of catheter-related superficial peripheral phlebitis of patients in neurological department by Cox regression model. Methods Single and multiple factor analysis were conducted by Cox regression model for the influence factors of peripheral phlebitis based on clinical data of patients in neurological department in three third-level first-class hosptials in Nanjing from June to August in 2015. Results Cox regression multi-factor analysis indicated that hypertonicity （HR=7.243, 95%CI：4.590-11.429,P〈0.001）, pH〉9（HR=4.683, 95%CI：2.274-9.642,P〈0.001）, pH〈5（HR=1.840, 95%CI：1.043-3.246, P=0.035）, cathetering in cubital fossa （HR=4.109, 95%CI：1.808-9.338,P〈0.001） and total daily infusion〉1 500 mL（HR=1.753, 95%CI：1.105-2.782, P=0.017）were risk factors for phlebitis. Conclusion Hypertonicity （〉600 mOsm/L）, pH〉9, pH〈5, cathetering in cubital fossa and total daily infusion〉1 500 mL exert influences on phlebitis of patients in neurological department.