NICU低出生体重儿PICC导管相关性血流感染的影响因素分析
Retrospective Analysis of Factors Influencing PICC-Related Bloodstream Infections in NICU Low Birth Weight Infant
吴贤琳 1尹转 1方玉琦 1向秋红 1杨小庆 1熊丽娟1
作者信息
- 1. 湖南师范大学附属长沙市妇幼保健院,长沙 410007
- 折叠
摘要
目的:探讨在新生儿重症监护病房(neonatal intensive care unit,NICU)的低出生体重儿中给予经外周穿刺中心静脉导管(peripherally inserted central catheters,PICC)置管的相关性血流感染的影响因素,为NICU开展PICC置管提供依据.方法:选取2021年1月―2022年6月在长沙市某三甲医院NICU住院并行PICC置管的低出生体重儿为研究对象.回顾性分析其临床资料,采用病例对照的方法,以发生导管相关性感染为病例组,未发生者为对照组,采用单因素分析和多因素Logistic回归分析探讨发生导管相关性血流感染的危险因素.结果:共有19例低出生体重儿发生导管相关性血流感染,总置管时长为3,466天,感染的发生率为每千导管日5.48例次.Logistic回归分析结果显示,出生体重＜1 000 g(OR=0.266,95%CI:0.084～0.842)及置管日龄≤7 d(OR=0.193,95%CI:0.057～0.653)是导管相关性血流感染的危险因素.出生体重、置管日龄两者联合,曲线下面积最大为0.741,约登指数为0.369,较单独更能有效地对低出生体重儿PICC导管相关性血流感染进行预测.结论:对于低出生体重儿,尤其是出生体重＜1 000 g的超低级出生体重儿以及置管日龄≤7天的早产儿,应该提高警惕,预防导管相关性血流感染的发生.
Abstract
Objective To explore the influencing factors of peripherally inserted central catheter(PICC)-related infec-tions in low birth weight infants in the Neonatal Intensive Care Unit(NICU)and provide a basis for PICC placement in NICUs.Methods We included low birth weight infants who were hospitalized in a tertiary hospital in Changsha City from January 2021 to June 2022 and underwent PICC placement.We retrospectively analyzed their clinical data,used a case-control method,with those who experienced catheter-related infections as the case group and those who did not as the control group.We conducted univariate and multivariate logistic regression analyses to investigate the risk factors for catheter-related bloodstream infections.Results A total of 19 low birth weight infants developed catheter-related bloodstream infections during a total catheterization duration of 3,466 days,with an infection rate of 0.5%per catheter day.The results of logistic regression analysis showed that birth weight＜1 000 g(OR=0.266,95%CI 0.084-0.842)and catheterization age≤7 days(OR=0.193,95%CI 0.057-0.653)were risk factors.Birth weight and the age at catheter placement,when combined,have a maximum area under the curve of 0.741 and an approximate odds ratio of 0.369.This combination is more effective in predicting Catheter-related bloodstream infection in low birth weight infants compared to individual factors alone.Conclusion For low birth weight infants,especially those with a birth weight of less than 1 000 g and premature infants with catheter placement at≤7 days of age,increased vigilance and preventive measures should be taken to reduce the occurrence of Catheter-related bloodstream infection.
关键词
NICU/低出生体重儿/外周静脉穿刺中心静脉导管/导管相关性血流感染Key words
NICU/low birth weight infants/peripherally inserted centralcatheters,/catheter-related bloodstream infection引用本文复制引用
基金项目
湖南省自然科学基金(2021JJ70127)
出版年
2024
NETL
NSTL
万方数据