Objective:Analysis venipuncture pattern of malignancies (HM) in patients with catheter related bloodstream infec-tions (CRBSI) and the influence of the risk factors of affect the occurrence of CRBSI.Methods:1335 cases between January 2016 and June 2017 hospitalized in four level of first class hospital onset of HM patients cases of venipuncture data were retrospectively analyzed, using the single factor analysis of data,in may with CRBSI related factors for Logistic multi factor analysis.Results:1335 patients with HM CRBSI 115 cases,infection rate 8.61%,femoral vein CRBSI48 cases(16.9%) and the internal jugular vein CRBSI for 29 cases (5.38%),compared the difference was statistically significant (P<0.05).Femoral vein catheter insufficient blood flow and conges-tion 29 cases(10.21%) and the internal jugular vein in 11 cases(2.04%),compared the difference was statistically significant(P<0.05).Internal jugular vein local hematoma or bleeding occurred 31 cases(5.76%) and 2 cases of femoral vein(0.70%),compared the difference was statistically significant(P<0.05).1335 patients with HM patients rejecting the same repetitive strain,separation of pathogenic bacteria of 156 strains of gram negative bacteria 90 strains(57.69%),62 strains(39.75%),gram positive bacteria isola-ted pathogenic bacteria mainly gram negative bacteria.Patients'age,number of venipuncture,venipuncture model HM patients and the influence factors,such as no correlation between the incidence of CRBSI,and its corresponding factor comparative difference was statis-tically significant (P<0.05).The single factor analysis of correlation and the incidence of CRBSI single factor into the Logistic regres-sion analysis of the results showed that all risk factors for inducing CRBSI,the difference was statistically significant(P<0.05).Con-clusion:Internal jugular vein catheter happen CRBSI infection rate (5. 38%),minimum femoral vein catheter infection rate (16.91%),in does not affect the clinical therapeutic effect as far as possible under the premise of the incidence of CRBSI lower mode of venipuncture catheter may be one of effective measures to reduce the incidence of CRBSI.Patients' age,puncture times,such as the mode of insertion are cause of CRBSI risk factors,risk factors should be targeted to strengthen hospital prevention,to reduce the inci-dence of CRBSI,improve HM patients survival rate and quality of life.%目的:分析静脉置管模式对恶性血液病(hematological malignancies,HM)患者导管相关血流感染(Catheter-related bloodstream infection,CRBSI)的影响及导致CRBSI发生的危险因素.方法:选取1335例在4家三级甲等医院血液科住院的HM患者行静脉置管的病例资料进行回顾性分析,采用单因素分析数据,对可能与发生CRBSI相关因素进行Logistic多因素分析.结果:1335例HM患者发生CRBSI 115例,感染发生率8.61%,股静脉发生CRBSI 48例(16.9%)与颈内静脉CRBSI 29例(5.38%),比较差异有统计学意义(P<0.05).股静脉发生导管血流量不足及堵塞29例(10.21%)与颈内静脉11例(2.04%)比较差异有统计学意义(P<0.05);颈内静脉发生局部血肿或出血31例(5.76%)与股静脉2例(0.70%)比较差异有统计学意义(P <0.05).1335例 HM 患者剔除同1患者的重复菌株共分离病原菌156株,其中革兰阴性菌90株(57.69%),革兰阳性菌62株(39.75%),分离出的病原菌以革兰阴性菌为主.患者年龄、静脉穿刺次数、静脉置管模式等因素与HM患者的CRBSI发生率存在相关性,其相对应因素比较差异有统计学意义(P<0.05).将单因素分析得出的与CRBSI发生率存在相关性的单因素纳入Logistic回归分析,结果显示均为诱发CRBSI的危险因素,差异有统计学意义(P<0.05).结论:颈内静脉置管模式发生CRBSI感染率最低(5.38%),股静脉置管感染率最高(16.91%),临床上在不影响治疗效果的前提下尽量采用CRBSI发生率较低的静脉置管模式置管可能是有效降低CRBSI发生率的措施之一;患者年龄、穿刺次数、置管模式等均为引发CRBSI的危险因素,医院应针对性地对危险因素加强预防,以降低CRBSI的发生率,提高HM患者的生存率和生活质量.
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