专业化PICC置管护理对肺癌患者导管相关性血流感染的影响

目的 探讨专业化PICC（peripherally inserted central catheter,PICC）置管护理对肺癌患者导管相关血流感染（catheter-related bloodstream infection,CRBSI）的影响,降低CRBIS的发生率,提高PICC护理质量.方法 回顾性分析585例肺癌患者置入PICC发生CRBSI情况和导管留置时间.将2009年1~12月置入PICC的198例患者作为非专业组,非专业组由护理组长对分管患者进行PICC置管及导管维护;将2010年1~12月置入PICC的387例患者作为专业组,专业组由PICC专职护士统一对所有患者进行PICC置管,对导管的维护进行全程质量监控.比较两组患者CRBSI的发生情况和导管留置时间.结果 专业组发生2例CRBSI,发生率0.52%,导管平均留置时间（114.4±48.7）d;非专业组发生3例CRBSI,发生率1.5%,导管平均留置时间（81.3±41.2）d.专业组与非专业组患者CRBSI、导管平均留置时间比较,差异有统计学意义（P＜0.05）.结论 专业化置管可提高PICC护理质量,能有效降低CRBSI的发生率,延长导管的留置时间.

The effect of specialized PICC catheter care on CRBSI in patients with lung cancer

Objective To explore the effects of catheter specialized P1CC care in lung cancer patients with CRBSI, re- duce the incidence of CRBIS PICC. Methods We retrospectively analyzed the incidence of CRBSI and catheter indwelling time in 585 cases of lung cancer patients placed PICC. 198 patients from January 2009 to December were placed in non-professional group, which were charged by nursing leader for PICC catheters and catheter maintenance. 387 patients from January 2010 to De- cember were placed in professional group, which were charged and full quality controlled by the full-time PICC catheter nurse. The occurrence ratio of CRBSI and the time of catheter were compared. Results The CRBSI incidence rate of professional group and non-professional group was 0. 52% （2/387）, 1.5% （3/198）, and the average catheter indwelling time was （114. 4 ± 48.7）d, （81.3± 41.2）d. The differences were statistically significant（P 〈 0. 05）. Conclusion Specialized catheter could improve the quality of PICC care, effectively reduce the incidence of CRBSI, and extend catheter indwelling time.