PICC置管后局部皮肤发生接触性皮炎的危险因素探讨

Risk factors that contribute to contact dermatitis in local skin in wake of PICC catheterization

目的探讨PICC置管后,患者局部皮肤发生接触性皮炎的危险因素,为临床采取针对性预防措施提供参考。方法回顾性分析270例PICC置管的恶性肿瘤患者临床资料,统计发生接触性皮炎的时间和程度,并对性别、年龄、体重指数、睡眠状态、药物过敏史、肿瘤类型、血嗜酸性粒细胞和嗜碱性粒细胞水平等可能引起接触性皮炎的影响因素进行单因素和多因素分析。结果有20例(7.41%)患者发生接触性皮炎,其中≤10d发生4例(20.00%),11~20d发生3例(15.00%),21~30d发生4例(20.00%),>30d发生9例(45.00%);轻度3例(15.00%),中度11例(55.00%),重度6例(30.00%)。单因素分析结果显示,不同性别、药物过敏史、睡眠状态、导管材质及敷贴种类的患者间接触性皮炎发生率差异有统计学意义(P<0.05);Logistic回归分析结果显示,性别、药物过敏史、睡眠状态、敷贴种类是PICC置管后局部皮肤发生接触性皮炎的独立危险因素(P<0.05)。结论男性、有药物过敏史、睡眠差、潮气通透率差的敷贴更易导致PICC置管患者局部皮肤发生接触性皮炎。

Objective To examine the possible risk factors that contribute to local contact dermatitis in the skin in wake of PICC catheterization so as to obtain scientific knowledge to inform clinical prevention practitioners. Methods Firstly, a retrospective analysis was conducted into the clinical data of 270 malignant tumors patients with PICC catheterization. Secondly, the extent and the time when contact dermatitis occurs were documented. Then possible factors such as gender, age, body mass index, sleep status, history of drug allergy, tumor type, blood eosinophils, and basophile levels that may contribute to the incidence of contact dermatitis were subjected to both univariate and multivariate analysis. Results The disease of contact dermatitis was found in 20 patients (7.41%). 4 cases (20.00%) occurred with the first 10 days after catheterization;3 cases (15.00%) were found 11~20 days after catheterization;4 cases (20.00%) were found 21~30 days after catheterization;and 9 cases (45.00%) were found 30 days after catheterization. 3 cases (15.00%) were found to be mild;11 cases (55.00%) were found to be moderate, and 6 cases (30.00%) severe. Univariate analysis showed gender, drug allergy history, sleep status, catheter material, and application type could lead to different rates of incidence of contact dermatitis ( P <0.05). Logistic regression analysis showed that gender, drug allergy history, sleep state, and application type were independent risk factors that give rise to local contact dermatitis in the skin in wake of PICC catheterization ( P <0.05). Conclusions Male gender, drug allergy, poor sleep, and poor moisture permeability are more likely to cause contact dermatitis in the skin of patients bearing PICC catheterization.