急性DVT患者CDT治疗中血管导管相关感染危险因素及病原菌分析

doi:10.20223/j.cnki.1000-8535.2025.12.013

摘要/Abstract

摘要： 目的通过对急性深静脉血栓形成（DVT）患者经导管接触性溶栓治疗（CDT）中,影响血管导管相关感染（VCAI）危险因素及病原菌分析,为VCAI的预防提供合理、有效的措施。方法收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料,回顾性调查患者诊疗相关资料及血培养结果,并对发生VCAI和病原菌情况进行分析。结果本研究共调查急性DVT行CDT治疗的患者437例,发生VCAI的患者共21例,千日感染率为0.543‰。多因素Logistic回归分析结果显示：溶栓频率>3次/天[OR=3.49（95%CI：1.86~6.45）]、导管留置时间>7 d[OR=3.86（95%CI：1.26~10.18）]和有导管回送[OR=8.67（95%CI：4.83~12.65）]是患者发生VCAI的危险因素（P<0.05）。发生VCAI的21例患者,血培养共培养出24株病原菌,有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见,共培养出13株,占比54.17%,革兰阴性菌9株,占比37.5 %。结论导管留置时间>7 d、溶栓频率>3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主,可合并其他病原菌感染,其中以革兰阳性球菌为主。

关键词: 急性深静脉血栓, 溶栓治疗, 血管导管相关感染, 危险因素, 病原菌

Abstract: Objective By analyzing the risk factors and pathogens of vessel catheter associated infection（VCAI）in patients with acute deep vein thrombosis（DVT）undergoing catheter directed thrombolysis（CDT）,to provide reasonable and effective measures for the prevention and treatment of VCAI ．Methods Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected,patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized,and the occurrence of VCAI and pathogenic bacteria was statistically analyzed．Results This study investigated 437 patients undergoing CDT treatment for acute DVT,and a total of 21 patients developed VCAI,with an infection rate of 0.543‰．The results of multiple Logistic regression analysis show that thrombolysis frequency>3 times/day（OR=3.49[95%CI：1.86-6.45]）,catheter retention days>7 days（OR=3.86[95%CI：1.26-10.18]）,and the presence of catheter return（OR=8.67[95%CI：4.83-12.65]） were risk factors for the occurrence of VCAI in patients．Among the 21 patients with VCAI,a total of 24 strains of pathogenic bacteria were discovered in blood culture,and 3 patients developed composite pathogen infections．Among them,Gram positive cocci were the most common,with a total of 13 strains cultured,accounting for 54.17%,9 strains of Gram negative bacteria,accounting for 37.5%．Conclusions The duration of catheter retention>7 days,thrombolysis frequency>3 times/day,and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment．The pathogen of VCAI is mainly single pathogen,which can be combined with other pathogens,among which Gram positive cocci are the main pathogen．

Key words: acute deep venous thrombosis, catheter directed thrombolysis, vessel catheter associated infection, risk factors, pathogens

张方方, 吴晓琴, 罗小虎, 张辉, 薛艳梅. 急性DVT患者CDT治疗中血管导管相关感染危险因素及病原菌分析[J]. 广州医药, 2025, 56(12): 1705-1711.

ZHANG Fangfang, WU Xiaoqin, LUO Xiaohu, ZHANG Hui, XUE Yanmei. Risk factors and pathogens analysis of vessel catheter associated infection in acute DVT patients undergoing CDT treatment[J]. Guangzhou Medical Journal, 2025, 56(12): 1705-1711.

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