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目的分析PICC相关感染的危险因素,旨在为临床预防导管相关性感染提供依据。方法采用Meta分析的方法对从建库开始至2015年12月为止公开发表的PICC相关感染危险因素的20篇文献进行定量综合分析。结果 PICC相关感染率为16.2%;各因素合并OR值及95%可信区间分别为:年龄≥66岁(4.83,4.16~5.60)、导管留置≥6月(5.03,5.02~5.03)、输注特殊药物(2.15,1.65~2.82)、合并基础疾病(2.98,2.05~4.32)、穿刺≥2次(1.85,1.45~2.35)、化疗>4次(2.23,1.81~2.75)、白细胞减少(2.87,2.31~3.55)、夏冬季节(3.04,1.97~4.67)、操作人员年资<5年(2.26,1.64~3.13)、穿刺经验<50次(2.20,1.71~2.81)、多腔导管(2.55,1.77~3.66)、换药频次>4d(3.28,1.92~5.60)、导管移动(4.47,2.05~9.74)、B超引导(0.92,0.88~0.97)。结论发生PICC相关感染的危险因素为高龄、导管留置时间长、输注特殊药物、合并基础疾病、反复穿刺、多次化疗、白细胞减少、夏冬季节、操作人员年资低、穿刺经验少、多腔导管、换药少及导管移动;保护因素为B超引导下穿刺。
Objective To analyze the risk factors associated with PICC infection and to provide a basis for clinical prevention of catheter-related infections. METHODS: Meta-analysis was used to quantitatively analyze 20 published articles of PICC-related risk factors that were published from the beginning of construction to December 2015. Results The infection rate of PICC was 16.2%. The combined OR and 95% confidence intervals of all factors were: age ≥66 years (4.83,4.16 ~ 5.60), catheter indwelling ≥6 months (5.03,5.02 ~ 5.03) (2.15, 1.65 ~ 2.82), basic diseases (2.98, 2.05 ~ 4.32), puncture≥2 times (1.85,1.45 ~ 2.35), chemotherapy more than 4 times (2.23,1.81 ~ 2.75), leucopenia (2.87, (2.26-1.64 ~ 3.13), puncture experience <50 times (2.20,1.71 ~ 2.81), multi-lumen catheter (2.55, 1.77 ~ 3.66), frequency of dressing> 4d (3.28,1.92 ~ 5.60), catheter movement (4.47,2.05 ~ 9.74) and B-guided ultrasound (0.92,0.88 ~ 0.97). Conclusions The risk factors of PICC related infection are elderly, catheter indwelling for a long time, infusion of special drugs, combined with basic diseases, repeated puncture, multiple chemotherapy, leucopenia, summer and winter, operators of seniority, less puncture experience, more Cavity catheter, dressing less and catheter movement; protection factor for B-guided puncture.