Johnson P R, Decker M D, Edwards K M, Schaffner W, Wright P F
J Infect Dis. 1986 Oct;154(4):570-8. doi: 10.1093/infdis/154.4.570.
Indwelling, right atrial catheters are important in the care of children with cancer, despite the risk of infection. We have reviewed the records of 64 pediatric oncology patients with 70 Broviac catheters. Fifty infections (17 exit site, 25 septic, and 8 combined) occurred during 17,581 catheter-days, a crude rate of 2.8 infections/1,000 catheter-days. The risk of infection correlated most strongly with age; for example, only children aged one through four years had multiple infections. Overall, 70% of infections were cured without removing the catheter, including 83% of septic infections. However, as compared with newly inserted catheters, the subsequent mean infection-free interval was greatly reduced for catheters associated with a previous, cured infection. Thus, although most Broviac catheter infections can be cured without catheter removal, insertion of a new catheter may nonetheless be necessary in patients who may need prolonged intravenous therapy.
尽管存在感染风险,但留置右心房导管在癌症患儿的护理中仍很重要。我们回顾了64例儿科肿瘤患者使用70根布罗维阿克导管的记录。在17581个导管日期间发生了50次感染(17次出口部位感染、25次败血症感染和8次合并感染),粗感染率为2.8次感染/1000导管日。感染风险与年龄的相关性最强;例如,只有1至4岁的儿童发生了多次感染。总体而言,70%的感染在不拔除导管的情况下得以治愈,其中83%的败血症感染得以治愈。然而,与新插入的导管相比,与先前已治愈感染相关的导管随后的平均无感染间隔时间大大缩短。因此,尽管大多数布罗维阿克导管感染可以在不拔除导管的情况下治愈,但对于可能需要长期静脉治疗的患者,仍可能需要插入新的导管。