神经内科住院患者经外周静脉置入中心静脉导管相关性血流感染发生风险研究

摘要

目的 探讨经外周静脉置入中心静脉导管(peripherally inserted central catheters,PICC)在非肿瘤住院患者应用中导管相关性血流感染(CRBSI)的发生风险.方法 连续性收集2014年6月1日～2017年6月1日于我院神经内科住院且接受PICC患者172例临床资料,分析其CRBSI的发生风险,并对国内住院患者PICC发生CRBSI的风险进行系统评价.结果 入选的172例患者中,61.7％置管发生在普通病房,38.3％置管于神经重症监护病房;87.8％合并尿管留置,29.7％合并机械通气.本研究共置管183例,中位置管时间35d,6例患者发生CRBSI,发病率为0.6/1000个导管日.9篇文献报道的国内有关PICC发生CRBSI的风险多集中于肿瘤患者,报道感染率差异性较大[(0.26～33.10)/100个导管].结论 PICC在神经内科住院患者中应用发生CRBSI的风险低于传统中心静脉置管.临床尚需进一步评估其在神经内科重症监护病房中的价值.%Objective To study the risk of bloodstream infection in relation with peripherally inserted central venous catheter (PICC) in hospitalized non-cancer patients.Methods Clinical data of 172 non-cancer patients admitted to our hospital for PICC were collected.The risk of PICC-related bloodstream infection (CRBSI) in domestic hospitalized non-cancer patients was analyzed and systematically assessed.Results Of the 183 PICCs placed in 172 patients included in this study,61.7％ were placed in general wards,38.3％ were placed in ICU,87.8％ were placed in combination with indwelling urinary catheter,29.7％ were placed in combination with mechanical ventilation.The median PICC indwelling time was 35 days.CRBSI occurred in 6 patients with an incidence of 0.6/1000 PICCs/day.The risk of CRBSI was centralized in domestic tumor patients after PICC.The reported CRBSI was significantly different in hospitalized non-cancer patients (0.26-33.10/100 PICC).Conclusion The risk of CRBSI is lower in hospitalized patients after PICC placement than after traditional central venous catheter placement.Further studies are needed to assess its value in ICU.