完全植入式静脉输液港相关感染的危险因素

目的了解完全植入式静脉输液港相关感染发病情况,探讨其危险因素。方法选取河南省某三甲医院2013年1月—2016年12月使用完全植入式静脉输液港的2 098例乳腺癌患者为研究对象。采用巢式病例对照研究方法,以监测期间出现输液港相关感染的26例患者为病例组,按照1∶2的比例,随机选取同期进行该类手术的52例患者为对照组,比较两组在一般资料、研究指标方面的差异。采用logistic回归模型进行输液港相关感染的危险因素分析。结果监测期间,输液港植入患者共置管274 838 d,26例患者发生输液港相关感染,发病率为1.24%,日发病率为0.09‰;感染病原体以表皮葡萄球菌为主(占30.77%);有糖尿病史(OR=3.61,95%CI:1.27~10.11)、置港时长≥90 d(OR=4.71,95%CI:1.65~13.22)、手术时长≥40 min(OR=3.60,95%CI:1.34~9.64)为患者发生输液港相关感染的独立危险因素。结论应加强对植入输液港患者的监测和随访,特别是对患有糖尿病、置管时间长、手术时间长的患者更应密切关注,以利于输液港相关感染的预防与控制。

Risk factors for totally implantable venous access port related infection

ObjectiveTo understand the occurrence of totally implantable venous access port（TIVAP） related infection, and explore its risk factors.MethodsA total of 2 098 patients with breast cancer who received TIVAP in a tertiary first class hospital in Henan Province between January 2013 and December 2016 were selected as the research subjects. By nested case control study, 26 patients with TIVAP related infection during monitoring period were selected as case group, according to the proportion of 1∶2, 52 patients undergoing the same kind of operation during the same period were randomly selected as control group, difference in general data and research indexes between two groups was compared. Logistic regression model was used to analyze the risk factors for TIVAP rela ted infection.ResultsDuring monitored period, the total TIVAP day was 274 838 days, 26 patients developed TIVAP related infection, incidence of TIVAP related infection was 1.24%, infection rate per 1 000 venous access day was 0.09‰; the main pathogen causing infection was Staphylococcus epidermidis (30.77%); independent risk factors for TIVAP related infection in patients were history of diabetes mellitus (OR, 3.61 ［95%CI, 1.27-10.11］), duration of venous access≥90 days (OR, 4.71 ［95%CI, 1.65-13.22］), and duration of operation≥40 minutes (OR, 3.60 ［95%CI, 1.34-9.64］). ConclusionIt is necessary to strengthen the monitoring and follow up of patients receiving TIVAP, especially for patients with diabetes mellitus, as well as long duration of cathete rization and operation, so as to prevent and control TIVAP related infection.