患有癌症和未患癌症儿童的中心静脉通路装置并发症
Complications of central venous access devices in children with and without cancer.
作者信息
Tobiansky R, Lui K, Dalton D M, Shaw P, Martin H, Isaacs D
机构信息
Department of Immunology and Infectious Diseases, Royal Alexandra Hospital for Children, Westmead, New South Wales, Australia.
出版信息
J Paediatr Child Health. 1997 Dec;33(6):509-14. doi: 10.1111/j.1440-1754.1997.tb01660.x.
OBJECTIVE
Complications of indwelling central venous access devices (CVAD) were assessed in 63 children with cancer and 35 without cancer.
METHODOLOGY
Central venous access devices placed surgically in 1991 were reviewed for complications.
RESULTS
In cancer patients, the median CVAD duration was 211 days (range 9-924), compared to 37 days (range 3-339) in the non-cancer patients. Although significantly more CVAD, 41 of 72 (57%), were infected in the cancer patients compared to 14 of 40 (35%) CVAD in the non-cancer patients (OR = 2.46, 95% CI 1.03-5.93), the rate of line infection in cancer patients was lower: 2.8 per 1000 catheter days compared with 7.6 per 1000 in non-cancer patients (P = 0.0014). Infection was significantly more common in intensive chemotherapy cancer patients (P = 0.0002).
CONCLUSIONS
Treating infected CVAD with antibiotics or hydrochloric acid (HCl), clearing occluded lines with streptokinase/HCl and repairing fractured lines, when successful, resulted in a considerable gain in the number of days of use for the CVAD.
目的
对63例癌症患儿和35例非癌症患儿留置中心静脉通路装置（CVAD）的并发症进行评估。
方法
回顾1991年手术置入的中心静脉通路装置的并发症情况。
结果
癌症患者CVAD的中位使用时长为211天（范围9 - 924天），而非癌症患者为37天（范围3 - 339天）。虽然癌症患者中CVAD感染的比例显著更高，72例中有41例（57%），而非癌症患者40例中有14例（35%）（比值比=2.46，95%置信区间1.03 - 5.93），但癌症患者的导管感染率更低：每1000导管日为2.8例，而非癌症患者为每1000导管日7.6例（P = 0.0014）。感染在强化化疗的癌症患者中更为常见（P = 0.0002）。
结论
用抗生素或盐酸（HCl）治疗感染的CVAD，用链激酶/HCl清除堵塞的导管并修复破裂的导管，若成功，可使CVAD的使用天数显著增加。
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