在重症患者中意外切除中央静脉导管的发生和危险因素:一个多中心队列研究
Xiaofeng He1,2,3, Chunlei Li1,2,4, Zhe Wang1,2,5
1Fudan University School of Nursing, Shanghai, China.
Nursing research and practice
|September 15, 2025
概括
非计划的中央静脉导管 (CVC) 摘除发生在5.71%的重症监护患者中,主要是由于感染. 男性性别,神经疾病和机械通风增加了风险,而紧急插入具有保护性.
科学领域:
- 关键护理医学 关键护理医学
- 血管接入装置 血管接入装置
- 患者安全 患者安全
背景情况:
- 中枢静脉导管 (CVC) 对重症患者至关重要.
- 无计划的心血管切除可以导致治疗中断,长时间住院,并增加死亡率.
- 识别 CVC 意外切除的风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 调查中国重症患者中非计划性心血管切除的发生率和风险因素.
- 为了确定患者的特征和与过早的心血管切除相关的临床因素.
主要方法:
- 一项多中心队列研究,涉及中国22家三级医院的2680个CVC插入.
- 考克斯的比例危险回归模型被用来分析 CVC 意外移除的风险因素.
- 数据收集时间为2023年9月4日至2024年2月29日.
主要成果:
- 非计划性心血管切除的发生率为5.71%,主要原因是感染相关的并发症 (4.63%).
- 无计划心血管切除的独立风险因素包括男性性别 (HR 2.04),神经系统疾病 (HR 2.41) 和机械通风 (HR 1.71).
- 紧急的CVC插入被发现是一种保护因素 (HR 0.52).
结论:
- 无计划的心血管切除是重症监护中的一个重要问题,感染是主要的驱动因素.
- 男性性别,神经疾病和机械通风是关键的危险因素.
- 建议针对性预防策略,重点关注这些因素,并促进紧急的CVC插入,以减少计划外移动.
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