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周围型肺癌化疗患者经外周静脉穿刺中心静脉置管后导管相关感染的危险因素分析

Analysis in risk factors of catheter-related infection after peripherally inserted central catheterization in patients with chemotherapy for peripheral lung cancer

    摘要
  • 摘要:
    目的 探讨周围型肺癌化疗患者经外周静脉穿刺中心静脉置管(PICC)后导管相关感染(CRI)的风险因素。
    方法 选取2017年4月—2020年12月河北省衡水市人民医院收治的周围型肺癌成年患者450例为研究对象，将其中发生PICC后CRI (局部感染27例，血流感染5例)的32例患者设为CRI组，另筛选年龄匹配的96例未感染患者设为对照组。使用院内自制的PICC导管维护记录册记录患者相关诊疗信息，包括性别、体质量、年龄、PICC导管留置时间、导管穿刺次数等。运用单因素分析与多因素Logistics回归分析探讨导致CRI的各项相关风险因素。
    结果 CRI组与对照组在肺癌分期、营养状况、PICC导管留置时间、PICC导管重复穿刺数、穿刺侧肢体运动幅度、化疗给药频数和合并糖尿病等方面比较，差异有统计学意义(P＜0.01)。多因素Logistics回归分析显示, CRI的风险因素为化疗给药频数(OR=6.386)、PICC导管位移(OR=2.512)、伴糖尿病等基础性疾病(OR=3.362)。
    结论 周围型肺癌化疗患者PICC后CRI有诸多风险因素，例如导管重复穿刺数、导管留置时间、导管位移、化疗给药频数和合并糖尿病等基础性疾病。临床护理时需运用针对性护理干预以降低CRI发生率，延长肿瘤患者生存期。

     

    Abstract:
    Objective To explore the risk factors of catheter-related infection (CRI) after peripherally inserted central catheterization (PICC) in patients with chemotherapy for peripheral lung cancer.
    Methods A total of 450 adult patients with peripheral lung cancer in Hengshui City People's Hospital of Hebei Province from April 2017 to December 2020 were selected as research objects. Among them, 32 patients with CRI after PICC (27 cases of local infection and 5 cases of blood flow infection) were selected as CRI group, and 96 age-matched uninfected patients were selected as control group. The self-made PICC catheter maintenance record book was used to record the relevant diagnosis and treatment information of patients, including gender, body mass, age, indwelling time of PICC catheter and number of catheter puncture. Univariate analysis and multivariate Logistic regression analysis were used to explore the relevant risk factors of CRI.
    Results There were significant differences in stages of lung cancer, nutritional status, indwelling time of PICC catheter, number of repeated PICC catheter puncture, range of motion of limbs on puncture side, frequency of chemotherapy administration and condition of complicating diabetes between the CRI group and the control group (P < 0.01). Multivariate Logistic regression analysis showed that the risk factors of CRI were frequency of chemotherapy administration (OR=6.386), PICC catheter displacement (OR=2.512) and complicating basic diseases such as diabetes (OR=3.362).
    Conclusion There are many risk factors for CRI after PICC in patients with chemotherapy for peripheral lung cancer, such as the number of repeated catheter puncture, indwelling time of catheter, catheter displacement, and frequency of chemotherapy administration and complicating basic diseases such as diabetes. Targeted nursing intervention should be used in clinical nursing to reduce the incidence of CRI and prolong the survival of tumor patients.

     

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