| 周 媛,骆 煜,胡琳琳,鲁 娜,江 莹.乳腺癌患者术后PICC导管相关性感染的危险因素及血清C反应蛋白、降钙素原对感染发生风险的预测价值[J].,2023,(2):289-293 |
| 乳腺癌患者术后PICC导管相关性感染的危险因素及血清C反应蛋白、降钙素原对感染发生风险的预测价值 |
| Risk Factors of Postoperative PICC Catheter-Related Infection in Patients with Breast Cancer and the Predictive Value of Serum C-Reactive Protein and Procalcitonin on the Risk of Infection |
| 投稿时间：2022-05-28 修订日期：2022-06-24 |
| DOI：10.13241/j.cnki.pmb.2023.02.016 |
| 中文关键词: 乳腺癌 PICC导管相关性感染 危险因素 C反应蛋白 降钙素原 预测价值 |
| 英文关键词: Breast cancer PICC catheter-related infection Risk factors C-reactive protein Procalcitonin Predictive Value |
| 基金项目:湖北省自然科学基金项目（2020CFA026） |
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| 中文摘要: |
| 摘要 目的：分析乳腺癌患者术后经外周静脉置入中心静脉导管（PICC）相关性感染的危险因素并探讨血清C反应蛋白（CRP）、降钙素原（PCT）对感染发生风险的预测价值。方法：选取2019年1月～2022年1月我院收治的150例乳腺癌改良根治术后接受PICC置管的乳腺癌患者，根据是否发生PICC导管相关性感染分为感染组34例和非感染组116例，收集患者临床资料，采用化学发光法检测置管前血清CRP、PCT水平。通过单因素和多因素Logistic回归分析乳腺癌患者术后PICC导管相关性感染的危险因素，绘制受试者工作特征（ROC）曲线分析血清CRP、PCT水平单独与联合检测对乳腺癌患者术后PICC导管相关性感染的预测价值。结果：单因素分析显示，与非感染组比较，感染组高血压病、糖尿病、TNM分期Ⅲ期、穿刺次数≥3次、化疗次数≥5次、导管留置时间≥6个月、敷料更换频率≥7 d/次比例和血清CRP、PCT水平更高（P＜0.05）。多因素Logistic回归分析显示，糖尿病、TNM分期Ⅲ期、化疗次数≥5次、导管留置时间≥6个月、敷料更换频率≥7 d更换1次、CRP（较高）、PCT（较高）为乳腺癌患者术后PICC导管相关性感染的危险因素（P＜0.05）。ROC曲线分析显示，血清CRP、PCT水平联合预测乳腺癌患者术后PICC导管相关性感染的曲线下面积（AUC）大于单独预测。结论：糖尿病、TNM分期、化疗次数、导管留置时间、敷料更换频率、血清CRP、PCT与乳腺癌患者术后PICC导管相关性感染相关，置管前血清CRP、PCT水平联合预测乳腺癌患者术后PICC导管相关性感染发生风险的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the risk factors of postoperative peripherally inserted central catheters (PICC)-related fection in patients with breast cancer and to explore the predictive value of serum C-reactive protein (CRP) and procalcitonin (PCT) on the risk of infection. Methods: 150 patients with breast cancer who received PICC catheterization after modified radical mastectomy in our hospital from January 2019 to January 2022 were selected. According to whether there was PICC catheter-related infection, they were divided into 34 cases in the infection group and 116 cases in the non-infection group. The clinical data of patients were collected, and the levels of serum CRP and PCT before catheterization were detected by chemiluminescence. The risk factors of PICC catheter-related infection in patients with breast cancer were analyzed by univariate and multivariate Logistic regression, and the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the levels of serum CRP and PCT alone and in combination for postoperative PICC catheter-related infection in patients with breast cancer. Results: Univariate analysis showed that compared with the non-infection group, the infection group had higher proportions of hypertension, dypertension, TNM stage Ⅲ, puncture times ≥3 times, chemotherapy times ≥5 times, catheter retention time ≥6 months, dressing change frequency ≥7 d/ time and the levels of serum CRP and PCT (P<0.05). Multivariate Logistic regression analysis showed that diabetes mellitus, TNM stage Ⅲ, chemotherapy times ≥5 times, catheter retention time ≥6 months, dressing change frequency ≥7 d replaced 1 time, CRP (higher), PCT (higher) were the risk factors for postoperative PICC catheter-related infection in patients with breast cancer (P<0.05). ROC curve analysis showed that the area under curve (AUC) of postoperative PICC catheter-associated infection predicted by serum CRP and PCT levels combined was greater than that predicted alone. Conclusion: Diabetes mellitus, TNM stage, chemotherapy times, catheter retention time, dressing change frequency, serum CRP and PCT are associated with postoperative PICC catheter-associated infections in patients with breast cancer, and the combined serum CRP and PCT levels before catheterization have a high value in predicting the risk of postoperative PICC catheter-related infection in patients with breast cancer. |
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