精细化防控干预对化疗患者PICC后导管相关性感染的影响

Effect of refined prevention and control intervention on catheter-related infection after PICC in chemotherapy patients

目的探讨精细化防控干预对化疗患者经外周置入中心静脉导管(PICC)后导管相关性感染的影响。方法选取2020年1月—2022年1月于郑州大学第一附属医院行PICC术的130例恶性肿瘤患者,采用随机数字表法分为对照组与观察组,每组65例。对照组患者采用常规防控干预,观察组患者在对照组基础上采用精细化防控干预。比较2组患者防控干预满意度、导管相关性感染以及导管不良事件发生情况,同时比较患者干预前后的心理状况和生存质量。结果观察组患者的防控干预满意度为93.85%(61/65),高于对照组的76.93%(50/65),差异有统计学意义(χ^(2)=7.459,P=0.006)。观察组患者干预后导管相关性感染发生率为1.54%(1/65),低于对照组的12.31%(8/65),差异有统计学意义(χ^(2)=4.298,P=0.038)。观察组患者干预后导管不良事件发生率为4.62%(3/65),低于对照组的18.46%(12/65),差异有统计学意义(χ^(2)=6.104,P=0.013)。2组患者干预前焦虑自评量表(SAS)及抑郁自评量表(SDS)评分比较,差异均无统计学意义(P>0.05);2组患者干预后SAS及SDS评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前卡氏功能状态量表(KPS)评分比较,差异无统计学意义(P>0.05);2组患者干预后KPS评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。结论精细化防控干预可降低化疗患者PICC后导管相关性感染及导管不良事件的发生风险,减轻患者负性情绪,提高患者生存质量。

Objective This paper aims to investigate the effect of refined prevention and control intervention on catheter-relat-ed infection after indwelling peripherally inserted central catheter(PICC)in patients undergoing chemotherapy.Methods A total of 130 patients with malignant tumors who underwent PICC in the First Affiliated Hospital of Zhengzhou University from January 2020 to January 2022 were randomly assigned to the control group and observation group,with 65 cases in each group.Patients in the control group received conventional prevention and control intervention;patients in the observa-tion group,refined prevention and control intervention based on the control group.The degree of satisfaction with preven-tion and control intervention,catheter-related infection,and occurrence of catheter-related adverse events were compared be-tween the two groups,and the psychological status and quality of life of the patients before and after intervention were also compared.Results The degree of satisfaction with prevention and control in the observation group was significantly higher than that in the control group[93.85%(61/65)vs.6.93%(50/65);χ^(2)=7.459,P=0.006].The incidence of catheter-related infection in the observation group after intervention was significantly lower than that in the control group[1.54%(1/65)vs.12.31%(8/65);χ^(2)=4.298,P=0.038].The incidence rate of catheter adverse events after intervention in the observation group was significantly lower than that in the control group[4.62%(3/65)vs.18.46%(12/65);χ^(2)=6.104,P=0.013].There were no significant differences in the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores before intervention between the two groups(P>0.05).The SAS and SDS scores after intervention in the two groups were decreased,and the observation group was lower than the control group,with statistical significance(P<0.05).There was no significant difference in Karnofsky performance status scale(KPS)score before intervention between the groups(P>0.05).The KPS score after intervention in both groups was increased,and the observation group was high-er than the control group,with statistical significance(P<0.05).Conclusion Refined prevention and control intervention can lower the risk of catheter-related infection and adverse events after PICC in patients undergoing chemotherapy,reduce the negative emotions of patients,and raise the quality of life of patients.