恶性肿瘤化疗病人PICC置管非计划性拔管的影响因素及防范措施

Influencing factors and preventive measures of unplanned extubation of PICC catheter in patients with malignant tumor chemotherapy

[目的]探讨经外周静脉置入中心静脉导管(PICC)的恶性肿瘤化疗病人非计划性拔管的影响因素,指导制定有效的防范措施。[方法]选择PICC置管的恶性肿瘤化疗病人162例,按照是否发生非计划性拔管分为非计划性拔管组36例和计划性拔管组126例,分析非计划性拔管状况并收集两组病人的一般资料及置管情况,然后采用多元线性回归分析PICC置管的恶性肿瘤化疗病人非计划性拔管的影响因素。[结果]非计划性拔管率为22.2%(36/162),主要原因有导管感染、堵塞等,两组病人的年龄及用药比较差异有统计学意义(P<0.05),而两组病人性别、基础疾病比较差异无统计学意义(P>0.05);非计划性拔管组病人的置管次数、置管位置、置管时间、敷贴种类以及导管外露长度与计划性拔管组比较差异均有统计学意义(P<0.05);多元Logistic回归分析显示,年龄、置管位置、置管时间以及导管外露长度是PICC置管的恶性肿瘤化疗病人非计划性拔管的影响因素。[结论]PICC置管的恶性肿瘤化疗病人非计划性拔管发生率较高,主要影响因素包括年龄、置管位置、置管时间以及导管外露长度,针对影响因素采取有效的防治措施,减少非计划性拔管的发生。

Objective:To explore the influencing factors of unplanned extubation in patients undergoing chemotherapy for malignant tumors with peripherally inserted central catheter(PICC),and to guide the formulation of effective preventive measures.Methods:A total of 162 patients with malignant tumors undergoing chemotherapy with PICC were selected in this study.According to whether unplanned extubation occurred,they were divided into unplanned extubation group with 36 cases and planned extubation group with 126 cases.The status quo of unplanned extubation was analyzed,and the general data and intubation status of the two groups of patients were collected.Chi-square test was used for Counting data and t-test for measurement data.Multiple linear regression analysis was used to analyze the influencing factors of unplanned extubation of PICC in patients undergoing chemotherapy for malignant tumors.Results:The incidence of unplanned extubation was 22.2%(36/162).The main reasons were catheter infection and blockage.There was a statistically significant difference in the age and medication of the two groups(P<0.05).There was no significant difference in gender and underlying diseases between the two groups(P>0.05).The differences in the number of catheter placements,place of catheter placement,catheter placement time,application type,and catheter exposure length of the two groups were statistically significant(P<0.05).Multivariate logistic regression analysis showed that age,place of catheter placement,catheter placement time,and catheter exposure length were the influencing factors for unplanned extubation of PICC in patients with chemotherapy for malignant tumors.Conclusions:The incidence of unplanned extubation of PICC in patients undergoing chemotherapy for malignant tumors was relatively higher.The main influencing factors included age,place of catheter placement,catheterization time,and catheter exposure length.Effective prevention and treatment measures should be taken to reduce the occurrence of unplanned extubation.