ABSTRACT
Objective:To analyze the causes of puncture wound infections induced by the high pressure resistant injectable PICC catheter in patients undergoing hematopoietic stem cell transplantation and management measures.Methods:linical data of 75 patients undergoing hematopoietic stem cell transplantation who were treated with the high pressure resistant injectable PICC catheter in our hospital from Nov.2017 to Nov.2019 were retrospectively analyzed.According to whether there were puncture wound infections, patients were divided into the infection group(n=26)and the non-infection group(n=49). Bacterial culture results of the infection group were recorded, and the related factors for puncture wound infections caused by the injectable PICC catheter were analyzed.Effective strategies to prevent high-risk factors, treatment frequency, treatment effect and healing time for patients with different degrees of puncture wound infections were discussed.Results:There were 26 patients in the infection group.The proportions of bacteria types associated with PICC catheter-related infections, in descending order, were as follows: Staphylococcus aureus(46.51%), Klebsiella pneumoniae(30.77%), Corynebacterium(15.38%)and others(7.69%). Significant differences were found in materials used, season of tube placement, timing of dressing changes, duration of catheterization, success rate of first tube placement and condition of dressing films between the non-infection and infection groups( t=5.5, 4.9, 5.0, 13.6, 9.4 and 6.2, all P<0.05). Logistic multi-factor analysis showed that non-U-shaped fixation, delay in dressing changes, long duration of tube placement, low success rate of first tube placement, and loose dressing films were the high-risk factors for PICC catheter-related infections( OR=2.78, 2.42, 3.16, 2.66 and 2.32, all P<0.05). Compared with patients with moderate and mild infections, patients with severe infections had a higher frequency of treatment, a lower total effectiveness rate and a longer healing time( F=10.353, 8.775 and 12.341, all P<0.05). Conclusions:Materials, timing of dressing changes, catheterization time, success rate of first tube placement and condition of dressing films are the high-risk factors for puncture wound infections caused by high pressure resistant injectable PICC catheters in patients undergoing hematopoietic stem cell transplantation.Developing effective intervention strategies can help control the incidence of wound infections.
ABSTRACT
Objective To evaluate the advantage and clinical value of javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma. Method Randomized controlled trials (RCTs) concerning javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma were made on electronic databases of CBM, CNKI, Wangfang, VIP and PubMed from 1990 to February 28, 2015. Quality of the included RCTs was assessed by Jadad scoring , and Meta-analyses were performed by RevMan5.3 software. Results Seven RCTs involving 575 patients were included in Meta-analysis. All studies were in low quality. The results of Meta-analyses showed that Javanica oil emulsion injection combined with radiotherapy for esophageal carcinoma, compared with control groups, could increase the recent curative effect (P < 0.000 01) and improve the quality of live (P = 0.000 8), decrease the hematologic toxicities (P = 0.03) and the incidence rate of radioaction esophagitis (P = 0.02), but not enough evidence was found to prove that it can enhance survival rate (P = 0.25). Conclusions The results of Meta-analysis indicate that javanica oil emulsion injection may have therapeutic effects on the treatment of esophageal carcinoma. Yet the effects of javanica oil emulsion injection still need to be confirmed by large multi-center randomized controlled trials.