上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (10): 1183-.doi: 10.3969/j.issn.1674-8115.2019.10.014

• 论著·临床研究 • 上一篇    下一篇

肿瘤患者上臂植入输液港相关感染发生率及危险因素研究

仇晓霞1*，金光鑫2*，郭 艳1，代孟君2，胡嘉娴1，张学彬2   

  1. 1.上海交通大学医学院附属仁济医院肿瘤科，上海200127；2. 上海交通大学医学院附属仁济医院肿瘤介入科，上海200127
  • 出版日期:2019-10-28 发布日期:2019-11-22
  • 通讯作者: 张学彬，电子信箱: zhangxuebin@renji.com。
  • 作者简介:仇晓霞（1974—）女，主任护师，硕士；电子信箱：chouxiaoxia@renji.com。金光鑫（1982—）男，主治医师，博士；电子信箱：jinguangxin@renji.com。﹡为共同第一作者。
  • 基金资助:
    上海交通大学医学院科技基金（Jyh1609）；上海交通大学医学院附属仁济医院培育基金（PYIII-17-019）

Incidence and risk factors of infection related to totally implanaccess port in upper arm in cancer patients

QIU Xiao-xia1*, JIN Guang-xin2*, GUO Yan1，DAI Meng-jun2, HU Jia-xian1, ZHANG Xue-bin2   

  1. 1. Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. Department of Interventional Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2019-10-28 Published:2019-11-22
  • Supported by:
    Foundation of Shanghai Jiao Tong University School of Medicine, Jyh1609; Foundation of Renji Hospital, Shanghai Jiao Tong University School of Medicine, PYIII-17-019

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摘要： 目的·探讨肿瘤患者上臂完全植入式输液港（totally implanaccess port，TIAP）植入后相关感染发生率及危险因素。方法·收集2014年2月—2018年12月上海交通大学医学院附属仁济医院接受上臂植入TIAP行化疗的1 961例患者临床资料，对患者一般资料、置管情况、感染细菌种类及TIAP相关感染发生率进行分析，采用单因素和多因素Logistic回归分析来确定上臂植入TIAP相关感染危险因素。结果·共43例患者出现上臂TIAP相关感染症状，发生率为2.2％（43/1 961）。上臂TIAP植入后至感染发生时间为（116.88±95.39） d（7～377 d）。感染者与未感染者各指标的比较结果显示，性别（P0.001）、导管直径（P0.000）、上肢静脉血栓（upper extremity venous thrombosis，UEVT）（P0.000）及门诊患者（P0.005）与感染风险有关。多变量二元回归分析结果显示性别（OR0.35，P0.012）、UEVT（OR31.59，P0.000）和导管直径（OR2.81，P0.005）是上臂TIAP相关感染的3个重要独立预测因子。结论·性别、UEVT及导管直径是上臂植入TIAP相关感染的独立危险因素。

关键词: 输液港, 上臂, 肿瘤患者, 感染

Abstract:

Objective · To explore the incidence and risk factors of infection related to totally implanaccess port (TIAP) in upper arm in cancer patients. Methods · A total of 1 961 patients who received TIAP for deliverance of chemotherapy at Renji Hospital, Shanghai Jiao Tong University School of Medicine during the period February 2014 to December 2018. The general clinical data, catheterization status, bacteriological data and incidence of TIAP-related infections were retrospectively analyzed. The univariate analysis and multivariate Logistic regression analysis were used to determine the risk factors TIAP-related infections. Results · A total of 43 patients developed TIAP-related infections, with an incidence of 2.2% (43/1 961). The mean time interval the implantation of upper arm TIAP to the diagnosis of infection was (116.88±95.39) d (7-377 d). In univariate analysis, gender (P0.001), catheter diameter (P0.000), upper extremity venous thrombosis (UEVT) (P0.000) and outpatient (P0.005) were significantly associated with the risk of infection related to upper arm TIAP. Multivariate binary Logistic regression analysis showed that gender (OR0.35, P0.012), UEVT (OR31.59, P0.000) and catheter diameter (OR2.81, P0.005) were three significant independent predictors of infection related to upper arm TIAP. Conclusion · Gender, UEVT and catheter diameter are independent risk factors for upper arm TIAP-related infection.

Key words: implanaccess port, upper arm, tumor patient, infection

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