肿瘤合并糖尿病患者导管相关性血流感染高危因素分析

Risk factors of catheter-related bloodstream infections in cancer patients with diabetes

目的调查肿瘤合并糖尿病患者经外周静脉穿刺置入中心静脉导管(PICC)相关性血流感染的发生率,分析导致发生血流感染的高危因素。方法选择2015年1月—2017年12月肿瘤科收治的60例肿瘤合并糖尿病接受PICC置管的患者为研究对象,收集患者临床资料并进行分析。结果观察期内,出现PICC相关并发症25(41.67%)例,其中导管相关血流感染7(11.67%)例。季节(OR=31.754,95%CI:7.134~115.377)、换药频次(OR=29.701,95%CI:6.882~121.083)和特殊药物使用(OR=178.341,95%CI:53.187~986.089)为PICC相关性血流感染的危险因素,文化程度(OR=0.018,95%CI:0.001~0.647)为保护因素。结论肿瘤合并糖尿病患者PICC导管相关性血流感染发生与季节因素、文化程度、换药频次和是否注射刺激性药物密切相关,在临床工作中加强患者的健康宣教,提高患者及家属的重视程度。

Objective To investigate the incidence of peripherally inserted central catheter（ PICC）-related bloodstream infections in cancer patients with diabetes,and to analyze related high risk factors. Methods Totally 60 cancer patients w ith diabetes received PICC catheterization for chemotherapy,their clinical data w ere collected and analyzed. Results There w ere 25（ 41. 67%） cases of PICC-related complications observed during treatment,in which 7 cases were PICC-related bloodstream infections. The season issue（ OR = 31. 754,95% CI： 7. 134 -115. 377）,frequency of changing dressing（ OR = 29. 701,95% CI： 6. 882 - 121. 083）,administration of special drugs（ OR = 178. 341,95% CI： 53. 187 - 986. 089） w ere risk factors of PICC-related bloodstream infections,and the education level（ OR = 0. 018,95% CI： 0. 001 -0. 647） w as the protective factor of PICC-related bloodstream infections. Conclusion The season issue,frequency of changing dressing,administration of special drugs and education level w ere associated w ith the PICC-related bloodstream infections in cancer patients w ith diabetes. It is required to enhance the health education and disease aw areness of patients and their family members.