A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies
A role for peripherally inserted central venous catheters in the prevention of catheter-related blood stream infections in patients with hematological malignancies
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DOI：
10.1007/s12185-014-1677-9
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发表时间：
2014-12-01
影响因子：
2.1
通讯作者：
Kato, Junji
中科院分区：
文献类型：
--
作者：
Sakai, Toshiro;Kohda, Kyuhei;Kato, Junji
中心静脉导管相关性血流感染（CR-BSI）是恶性血液病患者的严重并发症。然而，目前尚不清楚在这些患者中与传统类型的中心静脉导管（cCVC）和外周插入CVC（PICC）相关的CR-BSI发生率是否存在差异。为了解决这个问题，我们回顾性研究了血液恶性肿瘤患者中与PICC和cCVC相关的CR-BSI的发生率。我们在2009年2月至2013年2月期间需要CVC置入的所有连续患者中使用了PICC。我们比较了2006年9月至2009年1月期间接受治疗的PICC患者和cCVC患者（对照组）的CR-BSI率。84例患者接受了PICC，85例接受了cCVC。因导管相关并发症而取出的最常见原因是CR-BSI。PICC组CR-BSI发生率明显低于cCVC组（PICC组：1.23/1000置管日; cCVC组：5.30/1000置管日; P < 0.01）。PICC组中除CR-BSI以外的导管相关并发症发生率极低。PICC组的中位无导管相关并发症生存期显著长于cCVC组。我们的研究表明，PICC在血液系统恶性肿瘤患者中是有用的。
Central venous catheter-related blood stream infections (CR-BSIs) are a serious complication in patients with hematological malignancies. However, it remains unclear whether there is a difference in the rate of CR-BSI associated with the conventional type of central venous catheters (cCVCs) and peripherally inserted CVCs (PICCs) in such patients. To address this question, we retrospectively investigated the incidence of CR-BSIs associated with PICCs versus cCVCs in patients with hematological malignancies. We used PICCs in all consecutive patients requiring CVC placement between February 2009 and February 2013. We compared the CR-BSI rate in patients with PICCs with that in patients with cCVCs treated between September 2006 and January 2009 (control group). Eighty-four patients received PICCs and 85 received cCVCs. The most common reason for removal due to catheter-related complications was CR-BSI. The CR-BSI rate in the PICC group was significantly lower than that in the cCVC group (PICCs: 1.23/1000 catheter days; cCVCs: 5.30/1000 catheter days; P < 0.01). Catheter-related complications other than CR-BSIs occurred at an extremely low rate in the PICC group. The median catheter-related complication-free survival duration was significantly longer in the PICC group than in the cCVC group. Our study shows that PICCs are useful in patients with hematological malignancies.