接受全靜脈營養的成人病患發生中心靜脈導管感染的相關危險因子

Risk Factors Associated with Central Venous Catheter-Related Infections in Adult Patients Receiving Total Parenteral Nutrition

導管相關感染會延長接受全靜脈營養治療病人的住院天數以及增加醫療花費和死亡率。本研究是分析接受全靜脈營養治療的成年病人發生中心靜脈導管相關感染的危險因子。這是一個回溯性研究，經由病歷紀錄，分析四年內接受全靜脈營養治療的成年病人，臨床表現及檢驗結果，排除重複發生中心靜脈導管感染的病人。結果有412位病人進入研究，中心靜脈導管的置放有605次，54 位病人發生中心靜脈導管相關感染，感染率是13.1%。本研究顯示全靜脈營養治療的期間愈長、癌症病人、使用Port－A 導管的病人，會增加中心靜脈導管相關感染的風險。為了降低中心靜脈導管相關感染的發生，可以經由縮短全靜脈營養的使用時間和加強照護使用Port－A 導管及癌症病人的努力，達到目標。

Catheter-related infections prolong hospital stays and increase medical costs and mortality of patients receiving total parenteral nutrition(TPN). The aim of this study was to evaluate risk factors associated with central venous catheter-related infections in adult patients receiving TPN. This study was a 4-year retrospective analysis of adult patients receiving TPN, whose clinical and laboratory characteristics were recorded from medical records; patients with repeated central venous catheter-related infections were excluded. In total, 412 patients were analyzed, 605 insertions of a central venous catheter were carried out, and 54 patients had a central venous catheter related-infection, for an infection rate of 13.1%. This study showed that the longer the duration of TPN, patients suffering a malignancy, and the use of a Port-A catheter all increased the risk of a central venous catheter-related infection. In order to reduce the development of central venous catheter-related infections, the duration of TPN should be reduced, and care of patients suffering a malignancy or using a Port-A catheter should be enhanced.