51例乳腺癌化疗患者PICC导管相关感染的危险因素分析

Risk factors and intervention measures of PICC catheter-related infection in breast cancer patients with chemotherapy

目的外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管术是一种在肿瘤护理中广泛应用的技术,具备操作简单、安全性高的特点,具有广阔的发展前景。本研究旨在探讨乳腺癌化疗患者PICC导管相关感染的危险因素,并提出预防措施。方法选取2019-01-01-2019-12-31山东省肿瘤医院51例PICC导管相关感染的乳腺癌化疗患者作为病例组,选取同期102例未发生PICC导管相关感染的乳腺癌化疗患者作为对照组,采用病例对照的研究方法,使用单因素和多因素Logistic回归法分别筛选影响PICC导管相关感染的危险因素。结果单因素分析结果显示,年龄(χ^2=5.644,P=0.018)、居住地(χ^2=153,P<0.001)、留置时间(χ^2=40.936,P<0.001)、化疗周期(χ^2=13.866,P<0.001)和化疗方式(χ^2=4.665,P=0.031)等因素差异有统计学意义。多因素分析结果显示,留置时间(OR=2.085,95%CI:0.025~4.289,P<0.001)和化疗周期(OR=1.077,95%CI:0.031~2.195,P<0.001)是PICC置管感染的危险因素。结论留置时间和化疗周期是乳腺癌化疗患者PICC导管相关感染的危险因素。建立PICC置管制度,缩短置管时间,提高机体免疫力,加强导管维护,是降低PICC置管感染发生率的主要措施。

OBJECTIVE Peripherally inserted central catheter(PICC)is widely used in the clinical treatment of cancer.This study aimed to explore the risk factors of PICC catheterization infection in breast cancer patients with chemotherapy,and the intervention measures.METHODS A total of 51breast cancer patients with chemotherapy who had PICC catheterization infection were selected in the case group,and another 102breast cancer patients with chemotherapy who didn't have PICC catheterization infection were selected in the control group.In this case-control study,we used univariable and muhivariable logistic regression to detect possible risk factors of PICC catheterization infection.RESULTS The univariable logistic regression showed that age(χ^2=5.644,P=0.018),address(χ^2=153,P<0.001),catheterization time(χ^2=40.936,P<0.001),chemotherapy cycle(χ^2=13.866,P<0.001),chemotherapy(χ^2=4.665,P=0.031).In multivariable regression,catheterization time(OR=2.085,95%CI:0.025-4.289,P<0.001)and chemotherapy cycle(OR=1.077,95%CI:0.031-2.195,P<0.001)were risk factor of infection.CONCLUSION In view of the above risk factors,we should establish a strict PICC management system,shorten catheterization time and improve the immune function,strengthen the maintenance of catheter to prevent the occurrence of PICC catheterization infection.