白血病患者经外周静脉穿刺中心静脉置管致导管相关感染的危险因素分析
Analysis of Risk Factors of Peripherally Inserted Central Catheter Induced Catheter-related Infection in Patients with Leukemia.
作者信息
Zhou Lanlan, Wang Mingjun, Li Aping
机构信息
Dept. of Hematology and Oncology, The Second People's Hospital of Hefei, Hefei, Anhui, China.
Dept. of Hematology, Liaocheng People's Hospital, Liaocheng, Shandong, China.
出版信息
Iran J Public Health. 2017 Apr;46(4):485-490.
BACKGROUND
Peripherally inserted central catheter (PICC) is commonly used in nursing for patients with leukemia. The purpose of this study was to investigate the risk factors of Catheter-related infection (CRI) in patients with leukemia and to provide some nursing strategies based on the results.
METHODS
Clinical data from 140 patients with leukemia between May 2014 and July 2016 in Haiyang People's Hospital, China were retrospectively analyzed. We employed univariate analysis to explore the relationship of various factors, including leukemia types, puncture times, underlying diseases, Catheter indwelling time, hormones use, chemotherapy use, immune functions and seasons, with the incidence of CRI. Further, multivariate logistic regression analysis was conducted to identify the potential independent risk factors of CRI. Bacterial culture was performed for etiological detection.
RESULTS
Among the 140 patients with leukemia, 25 cases were diagnosed as CRI, with the incidence of 17.9%. Univariate analysis showed that puncture times, underlying diseases, catheter indwelling time, hormones use, chemotherapy use, immune functions and seasons were significantly correlated with the incidence of CRI. Multivariate logistic regression analysis revealed that immune functions, puncture times and seasons were independent risk factors for CRI. Etiological bacterial culture detected 20 strains of bacteria (: n=10, : n=4, : n=2 and other species: n=4) in 25 cases diagnosed with CRI.
CONCLUSION
Based on risk factors of CRI and its etiological distribution, appropriate nursing measures can be taken to reduce the incidence of CRI in patients with leukemia.
背景
外周静脉穿刺中心静脉导管（PICC）在白血病患者护理中常用。本研究旨在探讨白血病患者导管相关感染（CRI）的危险因素，并根据结果提供一些护理策略。
方法
回顾性分析2014年5月至2016年7月在中国海阳人民医院就诊的140例白血病患者的临床资料。我们采用单因素分析探讨白血病类型、穿刺次数、基础疾病、导管留置时间、激素使用、化疗使用、免疫功能和季节等各种因素与CRI发生率的关系。进一步进行多因素logistic回归分析以确定CRI的潜在独立危险因素。进行细菌培养以进行病因学检测。
结果
140例白血病患者中，25例被诊断为CRI，发生率为17.9%。单因素分析显示，穿刺次数、基础疾病、导管留置时间、激素使用、化疗使用、免疫功能和季节与CRI发生率显著相关。多因素logistic回归分析显示，免疫功能、穿刺次数和季节是CRI的独立危险因素。病因学细菌培养在25例诊断为CRI的患者中检测到20株细菌（：n = 10，：n = 4，：n = 2，其他菌种：n = 4）。
结论
根据CRI的危险因素及其病因分布，可采取适当的护理措施以降低白血病患者CRI的发生率。
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