Abstract:

Objective To analyze the cause and pathogenic process in patients with both catheter? related bloodstream infection and catheter?related large vein thrombosis （CRLVT）. Methods The central line?associated bloodstream infection （CLABSI） were investigated from tumor patients with PICC between May 2015 to April 2016. Of 863 case with PICC catheter，two cases were diagnosed as CLABSI combined with thrombosis. Results Management of anticoagulation，thrombolysis，systemic anti infection and symptomatic supportive treatment were performed ，and the infection and bone marrow suppression were controlled ，and the local symptoms subsided. After discharge ，oral anticoagulation therapy was continued for one month，and no special discomfort was observed in follow?up. In the two CLABSI patients，poor compliance，poor health situation，local rash，decreased immunity might be the mainly pathogenic factors. Conclusion CLABSI patients should be paid attention to occurrence of thrombosis. Clinical nursing work should be targeted to avoid the possible risk factors in patients with PICC catheter.

Key words: cancer patients, thrombosis, PICC catheter?related bloodstream infections

摘要：

目的 探讨2例肿瘤患者合并发生PICC导管相关性血栓和血流感染（CLABSI）的相关因素。方法 选取2015年5月～2016年4月我院863例肿瘤患者PICC置管中合并发生的2例PICC导管相关性血栓和血流感染患者进行总结分析。结果 2例患者经抗凝、溶栓、全身抗感染及对症支持治疗后，感染及骨髓抑制得到控制，局部症状消退，出院后继续口服抗凝治疗，一个月后随访无特殊不适；合并发生PICC相关性血栓和CLABSI的原因可能与患者维护依从性差、自身卫生状况差、皮疹、抵抗力低下等因素有关。结论 同时发生CLABSI和CRLVT是一个严重PICC导管相关并发症，发生CLABSI同时应检查有无血栓形成。临床护理工作中加强对PICC置管患者的护理应有针对性，规避以上可能的危险性因素。

关键词: PICC, 血栓, 导管相关性血流感染, 肿瘤患者