本文選題：腫瘤 + 導(dǎo)管插入術(shù)　； 參考：《中國(guó)全科醫(yī)學(xué)》2017年S1期

【摘要】：目的探究腫瘤患者經(jīng)外周靜脈置入中心靜脈導(dǎo)管(PICC)期間發(fā)生感染的危險(xiǎn)因素并探討其護(hù)理對(duì)策,為減少PICC相關(guān)性感染的護(hù)理提供理論依據(jù)。方法選取2015年10月—2016年10月浙江省金華市人民醫(yī)院治療的160例腫瘤化療患者,患者均行PICC。詳細(xì)記錄PICC期間患者發(fā)生感染的人數(shù),并采集標(biāo)本進(jìn)行病原學(xué)檢查,統(tǒng)計(jì)感染病原菌種類(lèi)及比例。對(duì)PICC相關(guān)性感染的危險(xiǎn)因素進(jìn)行單因素以及多因素Logistic回歸分析,并根據(jù)相應(yīng)的危險(xiǎn)因素探討合理的護(hù)理對(duì)策。結(jié)果 160例腫瘤患者PICC期間共發(fā)生相關(guān)感染26例,感染率為16.25%;采集26例患者的血標(biāo)本培養(yǎng)細(xì)菌22株,其中金黃色葡萄球菌12株、肺炎克雷伯菌6株、微小棒桿菌4株;激素藥物使用史、化療藥物使用史、合并癥、免疫功能、季節(jié)因素、穿刺次數(shù)、導(dǎo)管留置時(shí)間與腫瘤患者PICC感染具有相關(guān)性(P0.05);多因素Logistic回歸分析顯示,免疫功能、季節(jié)因素、穿刺次數(shù)是導(dǎo)致腫瘤患者PICC相關(guān)性感染的獨(dú)立危險(xiǎn)因素。結(jié)論激素藥物使用史、化療藥物使用史、合并癥、免疫功能、季節(jié)因素、穿刺次數(shù)、導(dǎo)管留置時(shí)間均與PICC相關(guān)性感染密切相關(guān),需要結(jié)合危險(xiǎn)因素以及患者自身情況制定合理的護(hù)理措施,用以降低PICC期間的感染率。
[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.
【作者單位】： 浙江省金華市人民醫(yī)院;
【分類(lèi)號(hào)】：R473.73

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