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目的:分析急性白血病患者经外周静脉置入中心静脉导管(peripherally inserted central catheter,P I C C)相关性感染因素,为有效防治提供理论依据。方法:选取保定市第一医院2 0 0 9年8月至2015年6月100例急性白血病患者及100例实体肿瘤患者行PICC置管,分析急性白血病PICC置管相关性感染发生率及原因。结果:100例急性白血病发生PICC置管相关性感染患者21例,置管相关性感染发生率为21.00%,其中局部感染12例,占12.00%,全身性感染9例,占9.00%;明显高于实体肿瘤患者10.00%(10/100),P<0.05,与患者年龄、性别、急性白血病类型、选择静脉、置管长度无显著相关。而中性粒细胞计数<0.5×109/L、粒细胞缺乏时间≥7 d,CD4/CD8<1.00、置管留置时间≥60 d患者置管相关性感染发生率明显升高。结论:白血病患者PICC置管相关性感染明显高于实体肿瘤患者,其中与中性粒细胞计数、粒细胞缺乏时间,CD4/CD8比值、置管留置时间密切相关,因此对急性白血病患者要严格执行PICC操作流程及无菌操作以减少患者置管相关性感染发生率。
Objective: To analyze the related infection factors of peripherally inserted central catheter (P I C C) in patients with acute leukemia and provide a theoretical basis for effective prevention and treatment. Methods: One hundred patients with acute leukemia from January 2009 to June 2015 in the First Hospital of Baoding and 100 patients with solid tumor underwent PICC catheterization to analyze the incidence and causes of PICC catheter-associated infection in acute leukemia. Results: Among 100 cases of acute leukemia, 21 cases were involved in PICC catheter-related infection and the incidence of catheter-related infection was 21.00%, of which 12 cases were local infection (12.00%) and 9 cases were systemic infection (9.00%), significantly higher In solid tumor patients 10.00% (10/100), P <0.05, and age, gender, type of acute leukemia, choice of vein, catheter length was not significantly correlated. Neutrophil count <0.5 × 109 / L, agranulocytosis more than 7 days, CD4 / CD8 <1.00, catheter indwelling time ≥ 60 d, the incidence of catheter-related infections increased significantly. Conclusion: PICC catheter-associated infection in patients with leukemia was significantly higher than that of solid tumor patients, which was closely related to neutrophil count, neutrophil time, CD4 / CD8 ratio and catheter indwelling time, so patients with acute leukemia should be strictly enforced PICC procedures and aseptic procedures to reduce the incidence of catheter-related infections in patients.