肿瘤患者PICC导管相关感染危险因素的Logistic回归分析

Logistic regression analysis of risk factors for PICC-related infection in tumor patients

目的探讨留置经外周静脉置入的中心静脉导管(PICC)的肿瘤患者发生导管相关性感染的危险因素。方法前瞻性追踪401例留置PICC肿瘤患者,分析患者发生导管相关性感染的相关因素,并进一步行Logistic回归分析。结果 401例留置PICC肿瘤患者的总导管留置时间为43 155 d,发生PICC导管相关性感染46例,感染率为1. 07/1 000导管日。单因素分析显示,MARSI史、经PICC输注刺激性药物、血小板水平、APTT水平、置管地点、置管次数、导管移动、导管维护周期延迟、维护人员资质对PICC导管相关感染的发生有影响,差异有统计学意义(P <0. 05);多因素分析提示,MARSI史、经PICC输注刺激性药物、置管次数是肿瘤PICC患者发生感染的独立危险因素;APTT水平、维护人员资质是其保护因素。结论针对危险因素应采取有效的预防处理措施,以期降低留置PICC的肿瘤患者发生导管相关性感染风险。

Objective To investigate the risk factors of catheter-related infection in tumor patients with indwelling peripherally inserted central catheters( PICC). Methods A prospective follow-up of 401 tumor patients with indwelling PICC was performed,and the related factors of catheter-related infection in the patients were analyzed and Logistic regression analysis was further performed. Results The total catheter indwelling time of 401 tumor patients with indwelling PICC was 43 155 d,46 cases of PICC-related infections occurred,and the infection rate was 1. 07/1 000 catheter days. Univariate analysis showed that MARSI history,PICC infusion of stimulating drugs,platelets level,APTT level,location of catheterization,number of times of catheterization,catheter movement,catheter maintenance cycle delay,and maintenance personnel qualifications had an impact on the occurrence of PICC-related infections,and the difference was statistically significant( P < 0. 05);multivariate analysis showed that MARSI history,PICC infusion of stimulating drugs,number of times of catheterization were independent risk factors for infection in tumor patients with PICC;APTT level,maintenance personnel qualification were its protective factors. Conclusion Effective precautions should be taken for risk factors in order to reduce the risks of catheter-related infections in patients with indwelling PICC.