Study on risk of hemorrhagic influenza infection in patients with PICC
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摘要: 目的 探讨行经外周静脉置入中心静脉导管(PICC)患者血栓和相关性血流感染发生的影响因素。 方法 选取2018年1—8月在中国科学院大学宁波华美医院行PICC的患者1 008例作为研究对象,收集患者的相关临床资料,包括一般资料、病史、实验室检查等,对患者进行血栓和相关性血流感染发生风险评估,统计分析相关危险因素,采用二元Logistic回归分析筛选血栓和相关性血流感染发生的危险因素。 结果 1 008例患者共计45例发生血栓,发生率为4.46%;15例发生相关血流感染,感染率为1.49%。对于不同导管留置时间的患者,其相关血流感染发生率差异有统计学意义(P<0.05)。二元Logistic回归分析显示,穿刺静脉和FIB含量是血栓发生的独立危险因素,而长时间的PICC导管留置是发生导管相关性血流感染的独立危险因素。 结论 行PICC的患者具有较高的血栓形成和导管相关性血流感染并发症的发生风险,其中患者的凝血指标、穿刺静脉的选择对血栓发生影响较大,长时间留置PICC是导致患者发生导管相关性血流感染的独立危险因素。因此护理人员应加强对行PICC患者血栓和相关性血流感染并发症的认识,采取具有针对性的、有预见性的分级护理干预措施,通过药物预防和分级护理措施来降低患者导管相关性血栓的发生。
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关键词:
- 经外周静脉穿刺置入中心静脉导管 /
- 血栓 /
- 血流感染 /
- 影响因素
Abstract: Objective To investigate the influencing factors of the occurrence of thrombosis and blood flow infection in patients undergoing peripherally inserted central catheter (PICC). Methods A total of 1 008 patients with PICC in our hospital from January 2018 to August 2018 were selected as subjects. The clinical data, including general data, medical history, laboratory examination, were collected. Bivariate logistic regression analysis was used to screen the risk factors of thrombosis and related bloodstream infection. Results Thrombosis occurred in 45 out of 1 008 patients, the incidence was 4.46%. A total of 15 patients with PICC had bloodstream-related infections, the infection rate was 1.49%. Bivariate Logistic regression analysis showed that prolonged indwelling of PICC catheter was an independent risk factor for catheter-related bloodstream infection, puncture vein and FIB content were independent risk factors for thrombosis. Conclusion PICC patients have a high risk of thrombosis and complications of catheter-related bloodstream infections. Coagulation parameters and selection of puncture veins have a great impact on the occurrence of thrombosis. Long-term indwelling of PICC is an independent risk factor for catheter-related bloodstream infections. Therefore, on the one hand, nurses should strengthen the understanding of the complications of PICC patients with thrombosis and related hemorrhagic influenza infection, adopt targeted and predictable grading nursing intervention measures, and reduce the incidence of catheter-related thrombosis through drug prevention and grading nursing measures.
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