肿瘤患者经外周静脉置入中心静脉导管相关性感染的危险因素及护理对策

发布时间：2018-05-29 06:41

本文选题：肿瘤 + 导管插入术　；参考：《中国全科医学》2017年S1期

【摘要】：目的探究肿瘤患者经外周静脉置入中心静脉导管(PICC)期间发生感染的危险因素并探讨其护理对策,为减少PICC相关性感染的护理提供理论依据。方法选取2015年10月—2016年10月浙江省金华市人民医院治疗的160例肿瘤化疗患者,患者均行PICC。详细记录PICC期间患者发生感染的人数,并采集标本进行病原学检查,统计感染病原菌种类及比例。对PICC相关性感染的危险因素进行单因素以及多因素Logistic回归分析,并根据相应的危险因素探讨合理的护理对策。结果 160例肿瘤患者PICC期间共发生相关感染26例,感染率为16.25%;采集26例患者的血标本培养细菌22株,其中金黄色葡萄球菌12株、肺炎克雷伯菌6株、微小棒杆菌4株;激素药物使用史、化疗药物使用史、合并症、免疫功能、季节因素、穿刺次数、导管留置时间与肿瘤患者PICC感染具有相关性(P0.05);多因素Logistic回归分析显示,免疫功能、季节因素、穿刺次数是导致肿瘤患者PICC相关性感染的独立危险因素。结论激素药物使用史、化疗药物使用史、合并症、免疫功能、季节因素、穿刺次数、导管留置时间均与PICC相关性感染密切相关,需要结合危险因素以及患者自身情况制定合理的护理措施,用以降低PICC期间的感染率。
[Abstract]:Objective to explore the risk factors of infection in patients with tumor during central venous catheterization via peripheral vein, and explore the nursing strategies, so as to provide a theoretical basis for the reduction of PICC related infection. Methods 160 patients treated with chemotherapy in Jinhua people's Hospital of Zhejiang Province from October 2015 to October 2016 were treated with PICC. The number of patients infected during PICC was recorded in detail, and samples were collected for etiological examination, and the species and proportion of pathogenic bacteria were counted. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of PICC related infection, and the reasonable nursing countermeasures were discussed according to the corresponding risk factors. Results there were 26 cases (16.25%) of related infections during PICC, 22 strains of bacteria were collected from blood samples of 26 cases, including 12 strains of Staphylococcus aureus, 6 strains of Klebsiella pneumoniae, 4 strains of Corynebacterium minimus. The history of hormone drug use, chemotherapy drug use, complications, immune function, seasonal factors, puncture times and catheter indwelling time were correlated with PICC infection in tumor patients (P 0.05). Puncture frequency is an independent risk factor for PICC-associated infection in cancer patients. Conclusion the history of hormone drug use, chemotherapy drug use, complications, immune function, seasonal factors, puncture times and catheter indwelling time are closely related to PICC related infection. Reasonable nursing measures should be developed in combination with risk factors and patients' own conditions to reduce the infection rate during PICC.
【作者单位】：浙江省金华市人民医院;
【分类号】：R473.73

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