外周静脉穿刺中心静脉置管（PICC）的血液病患者的导管相关血流感染及血栓形成风险
Catheter-associated bloodstream infections and thrombotic risk in hematologic patients with peripherally inserted central catheters (PICC).
作者信息
Morano Salvatore Giacomo, Latagliata Roberto, Girmenia Corrado, Massaro Fulvio, Berneschi Paola, Guerriero Alfonso, Giampaoletti Massimo, Sammarco Arianna, Annechini Giorgia, Fama Angelo, Di Rocco Alice, Chistolini Antonio, Micozzi Alessandra, Molica Matteo, Barberi Walter, Minotti Clara, Brunetti Gregorio Antonio, Breccia Massimo, Cartoni Claudio, Capria Saveria, Rosa Giovanni, Alimena Giuliana, Foà Robin
机构信息
Dipartimento di Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, "Sapienza" University of Rome, Via Benevento 6, 00161, Rome, Italy.
Dipartimento di Anestesiologia e Terapia Intensiva, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
出版信息
Support Care Cancer. 2015 Nov;23(11):3289-95. doi: 10.1007/s00520-015-2740-7. Epub 2015 Apr 26.
PURPOSE
The use of peripherally inserted central catheters (PICC) as an alternative to other central venous access devices (CVAD) is becoming very frequent in cancer patients. To evaluate the impact of complications associated to these devices in patients with hematologic malignancies, we revised the catheter-related bloodstream infections (CRBSI) and the catheter-related thrombotic complications (CRTC) observed at our institute between January 2009 and December 2012.
METHODS
A total of 612 PICCs were inserted into 483 patients at diagnosis or in subsequent phases of their hematologic disease. PICCs were successfully inserted in all cases. The median duration of in situ PICC placement was 101 days (interquartile range, 48-184 days).
RESULTS
A CRBSI occurred in 47 cases (7.7 %), with a rate of 0.59 per 1000 PICC days. A CRTC was recorded in 16 cases (2.6 %), with a rate of 0.20 per 1000 PICC days. No serious complication was associated to these events. Cox regression analyses of variables associated to CRBSIs and to CRTCs showed that only the type of disease (acute leukemia compared to other diseases) was significantly associated to a higher incidence of CRBSIs, while no feature was predictive for a higher risk of CRTCs.
CONCLUSIONS
PICCs represent a useful and safe alternative to conventional CVAD for the management of patients with hematologic malignancies.
目的
在癌症患者中，使用外周静脉穿刺中心静脉导管（PICC）作为其他中心静脉通路装置（CVAD）的替代方法正变得越来越普遍。为了评估这些装置相关并发症对血液系统恶性肿瘤患者的影响，我们回顾了2009年1月至2012年12月在我院观察到的导管相关血流感染（CRBSI）和导管相关血栓形成并发症（CRTC）。
方法
在483例血液系统疾病诊断时或后续阶段的患者中总共插入了612根PICC。所有病例PICC均成功插入。PICC在位放置的中位持续时间为101天（四分位间距，48 - 184天）。
结果
发生CRBSI 47例（7.7%），发生率为每1000个PICC日0.59例。记录到CRTC 16例（2.6%），发生率为每1000个PICC日0.20例。这些事件均未伴有严重并发症。对与CRBSI和CRTC相关变量的Cox回归分析显示，只有疾病类型（急性白血病与其他疾病相比）与CRBSI的较高发生率显著相关，而没有特征可预测CRTC的较高风险。
结论
对于血液系统恶性肿瘤患者的管理，PICC是传统CVAD的一种有用且安全的替代方法。
Zotero 插件