植入式静脉输液港相关感染并发症风险因素分析

Implantable venous access port- related infection: analysis of its risk factors

目的探讨植入式静脉输液港(IVAP)应用患者发生导管相关感染并发症的风险因素。方法收集2012年1月至2015年12月接受IVAP植入治疗的582例患者临床资料,对患者一般临床资料、细菌学资料、病情进展情况及IVAP相关感染发生率进行回顾性分析。结果 14例(2.4%,14/582)患者出现感染症状后取出IVAP,IVAP相关感染发生率为67例/千导管日。单因素分析显示住院患者(P=0.016)、恶性血液疾病患者(P=0.040)及接受姑息性化疗患者(P=0.022)感染率较高。多变量二元回归分析结果显示,恶性血液疾病及姑息性化疗患者发生感染的校正OR值分别为7.769(P=0.001)、4.863(P=0.003)。9例血液样本中细菌培养为阳性,最常见者为葡萄球菌(n=4)及念珠菌(n=2)。结论恶性血液病和姑息性化疗,可能是引起IVAP相关感染的独立危险因素。

Objective To investigate the incidence and risk factors of catheter-related infections in patients receiving implantable venous access port （IVAP）. Methods A total of 582 patients, who received IVAP at authors＇ hospital during the period from January 2012 to December 2015, were included in this study. The general clinical data, bacteriological data, disease progression and the incidence of IVAP-related infections were retrospectively analyzed. Results IVAP device was removed in 14 patients （14/582, 2.4%） when they developed infection symptoms. The incidence of IVAP- related infections was 67 cases/1000 catheter-days. Univariable analysis showed that the infection rate was higher in the hospitalized patients （P= 0.016）, in the patients with malignant hematologic diseases （P=0.040）, and in the patients receiving palliative chemotherapy （P=0.022）. Multivariate binary logistic regression analysis indicated that the adjusted OR values for infection rate in patients with malignant hematologic diseases and in patients receiving palliative chemotherapy were 7.769 （P=0.001） and 4.863 （P=0.003）, respectively. Positive bacteria culture was confirmed in 9 patients, and the most causative organisms were staphylococcus （n=4） and candida （n= 2）. Conclusion The underlying malignant hematologic diseases and the use of palliative chemotherapy may be the independent risk factors for IVAP-related infections.