乳腺癌患者携带PICC化疗并发导管败血症的诊治探讨.doc

PAGE PAGE 5 乳腺癌患者携带PICC化疗并发导管败血症的诊治探讨 邢雷 孔令泉 厉红元 任国胜 罗凤 吴凯南 （重庆医科大学附属第一医院内分泌乳腺外科，重庆，400016） 【摘要】目的 探讨乳腺癌患者携带PICC化疗出现导管败血症的发生及其临床诊断和防治。方法 回顾性分析我院2009年8月-2011年7月携带PICC化疗的187例乳腺癌患者中导管败血症的发生及其诊治情况。结果 187例携带PICC化疗的乳腺癌患者，共放置PICC188根，PICC管总置管时间为14,399天，平均置管时间为76.6天，最长170天。2例患者分别在PICC置管后29和108d(平均68.5d)出现导管败血症，其发生率为1.06%，发病密度为0.14/PICC置管1000天（0.14‰）。结论 乳腺癌患者化疗期间携带PICC化疗是一种安全有效的方法。但少数病例有可能出现导管败血症，应注意观察相关症状和体征，早期发现、对临床表现疑似PICC导管败血症患者不应拘泥于血培养结果，及时拔除PICC管，患者多能获得较好的疗效。 【关键词】乳腺癌；PICC；导管相关性败血症 【中图分类号】R730 【文献标识码】A 【作者简介】邢雷（1986-），男，浙江省嵊州人，临床医学七年制硕士研究生，主要研究方向为乳腺癌诊治。 【通讯作者】孔令泉（1973-），男，医学博士，副教授,主要进行乳腺癌的基础与临床研究。E-mail： huihuikp@163.com。 Diagnosis and treatment for PICC-related sepsis in patients with breast cancer Xing Lei, Kong Lingquan, Li Hongyuan, Ren Guosheng, Luo Feng, Wu Kainan. Department of Endocrine and Breast Surgery，First Affiliated Hospital，Chongqing Medical University，Chongqing 400016 Corresponding author: Kong Lingquan, E-mail: huihuikp@163.com. 【Abstract】 0bjective To study the incidence，diagnosis and treatment for PICC-related sepsis in patients with breast cancer during chemotherapy. Methods Retrospectively analyze the data of the incidence, diagnosis and treatment for PICC-related sepsis in 187 patients with breast cancer during chemotherapy，from August，2009 to July，2011. Results 188 PICCs were inserted since August，2009 to July，2011 and followed for a total of 14,399 catheter-days (median placement, 76.6 days; range, 1 to 170 days). In all, 2 (1.06%) of 188 PICCs were removed as a result of PICC-related sepsis in 29 and 108 catheter-days, for a rate of 0.14 per 1,000 catheter-days. Conclusions Application of PICC in patients with breast cancer during chemotherapy is a safe and modus operandi. However some patients may develop catheter-related sepsis. In order to get a good therapeutic effect, we should pay attention to its signs and symptoms instead of the blood culture results. 【Key words】 Breast cancer; PICC; catheter-related seps