骨感染病人经外周导入中心静脉导管后相关并发症的危险因素分析

摘要

目的 探讨骨感染病人外周导入中心静脉导管(PICC)后相关并发症的危险因素.方法 选取145例行PICC置管的骨感染病人的临床资料.分析PICC置管后相关并发症的发生率,采用非条件多因素Logistic统计分析其危险因素,并提出相应的预防对策.结果 145例骨感染病人中发生PICC置管后相关并发症27例,发生率为18.62%,并发症以导管相关性感染为主.非条件多因素Logistic回归分析显示,病人年龄、PICC置管操作护士年资、导管管腔数、导管留置时间、是否有其他自身疾病是病人PICC置管后发生相关并发症的独立危险因素(P<0.05),是否有其他自身疾病经哑变量处理后,患糖尿病与免疫抑制类疾病有统计学意义(P<0.05).结论 病人年龄大于65岁、患糖尿病或免疫抑制类疾病、PICC置管操作护士年资小于10年、使用双腔PICC导管及导管留置时间大于20 d是引起PICC置管后发生相关并发症的危险因素,应及时给予相应临床预防与护理措施,减少并发症发生.%Objective To investigate the risk factors of related complications in orthopedic inpatients with bone infection after peripher-allyinsertedcentralcatheters(PICC).Methods The clinical data of 145 cases of orthopedic inpatients with bone infection were retro-spectively analyzed.The incidence of related complications after PICC was analyzed.The risk factors were also analyzed by non-condi-tional multivariate logistic regression analysis and then relevant preventive measures were put forward.Results Relatedcomplications after PICC occurred in 27 patients among 145 patients,and the incidence was 18.62%.Catheter-related infections were the main com-plication.The non-conditional multivariate logistic regression analysis showed that age of patients,working years of nurses in PICC oper-ation,number of PICC lumens,PICC indwelling time and underlying other illness (handled with dummy variable)were independent risk factors of related complications after PICC(P<0.05 ).Diabetes and immunosuppressive diseases were statistically significant (P<0. 05).Conclusions This study has found out that patients>65 years old,bone infection complicated with diabetes or immunosuppres-sive diseases,working years of nurses in PICC operation <10 years,number of PICC lumen #2 and PICC indwelling time of more than 20 days are the risk factors of related complications after PICC.Clinical prevention and nursing measures are essential to prevent related complications after PICC.