肿瘤患者同时发生PICC导管相关性血栓和血流感染的病例分析

目的探讨2例肿瘤患者合并发生PICC导管相关性血栓和血流感染(CLABSI)的相关因素。方法选取2015年5月~2016年4月我院863例肿瘤患者PICC置管中合并发生的2例PICC导管相关性血栓和血流感染患者进行总结分析。结果 2例患者经抗凝、溶栓、全身抗感染及对症支持治疗后,感染及骨髓抑制得到控制,局部症状消退,出院后继续口服抗凝治疗,一个月后随访无特殊不适;合并发生PICC相关性血栓和CLABSI的原因可能与患者维护依从性差、自身卫生状况差、皮疹、抵抗力低下等因素有关。结论同时发生CLABSI和CRLVT是一个严重PICC导管相关并发症,发生CLABSI同时应检查有无血栓形成。临床护理工作中加强对PICC置管患者的护理应有针对性,规避以上可能的危险性因素。

Cancer patients with PICC catheter related bloodstream infection with thrombosis:A case analysis

ObjectiveTo analyze the cause and pathogenic process in patients with both catheter?related bloodstream infection and catheter?related large vein thrombosis （CRLVT）. Methods Thecentral line?associated bloodstream infection （CLABSI）were investigated from tumor patients withPICC between May 2015 to April 2016. Of 863 case with PICC catheter，two cases were diagnosed asCLABSI combined with thrombosis. Results Management of anticoagulation，thrombolysis，systemic antiinfection and symptomatic supportive treatment were performed ，and the infection and bone marrowsuppression were controlled ，and the local symptoms subsided. After discharge ，oral anticoagulationtherapy was continued for one month，and no special discomfort was observed in follow?up. In the twoCLABSI patients，poor compliance，poor health situation，local rash，decreased immunity might be themainly pathogenic factors. Conclusion CLABSI patients should be paid attention to occurrence ofthrombosis. Clinical nursing work should be targeted to avoid the possible risk factors in patients withPICC catheter.