Band J D, Maki D G
Arch Intern Med. 1980 Jan;140(1):31-4.
We studied the morbidity associated with steel needles used for intravenous therapy in adults with hematologic malignancy. Of 148 needles, 52 (36.1%) produced local inflammation, increasing with placements exceeding 24 hours, use of dextrose-containing infusate or intravenous antibiotics, granulocytopenia, and local infection. Eight needles (5.4%) caused local infection and three (2.1%) caused septicemia. Of nine bacteremias occurring in the 43 study patients, none of the five caused by Gram-negative bacilli, but three of the four caused by staphylococci, originated from steel needles. Five of eight local infections and all septicemias occurred with placements exceeding 72 hours (P = .016); each patient with septicemia was granulocytopenic. Intravenous steel needles are a major source of morbidity in patients with granulocytopenia or who are otherwise immunologically compromised. The insertion site should be routinely rotated at least every three days. Nosocomial staphlococcal bacteremia in granulocytopenic patients is likely to be due to an intravenous needle or similar device used for vascular access.
我们研究了血液系统恶性肿瘤成年患者静脉治疗使用钢针相关的发病率。在148根钢针中，52根（36.1%）引发了局部炎症，炎症发生率随置管时间超过24小时、使用含葡萄糖的输注液或静脉用抗生素、粒细胞减少以及局部感染而增加。8根钢针（5.4%）导致局部感染，3根（2.1%）导致败血症。在43例研究患者发生的9次菌血症中，5例由革兰阴性杆菌引起的菌血症中无一例源于钢针，但4例由葡萄球菌引起的菌血症中有3例源于钢针。8例局部感染中的5例以及所有败血症均发生在置管时间超过72小时的情况下（P = 0.016）；每例败血症患者均有粒细胞减少。静脉钢针是粒细胞减少患者或其他免疫功能受损患者发病的主要来源。置管部位应常规至少每三天更换一次。粒细胞减少患者的医院内葡萄球菌菌血症很可能是由于用于血管通路的静脉钢针或类似装置所致。
