Infection Rate of Hickman Catheters Versus Peripherally Inserted Central Venous Catheters in Oncology Patients
WY Wong, WCS Chan, SK Ip, WK Ng, CX Chan, HM Ho, KL Siu, CB Tan
Hong Kong J Radiol 2015;18:197-204
DOI: 10.12809/hkjr1514289
Objective: To compare the incidence of catheter-related infection in the bloodstream and non-infectious complication rate of Hickman catheter and peripherally inserted central venous catheter (PICC) in oncology patients.
Methods: A retrospective study was performed of oncology patients who underwent Hickman catheter or PICC placement at the radiology department of a regional hospital in Hong Kong from January 2008 to December 2013. The catheter-related bloodstream infection rate, time to infection onset, and non-infectious complication rate of the Hickman group and PICC group were evaluated and compared.
Results: During the study period, 161 Hickman catheters and 29 PICCs were inserted in oncology patients (n = 190). There were 38 cases of catheter-related bloodstream infection in the Hickman group and four cases in the PICC group. The catheter-related bloodstream infection rate for all catheters, Hickman group, and PICC group was 1.364, 1.340 and 1.654 per 1000-catheter-days, respectively. For non-infectious complications, 15 of 161 Hickman cases had complications (6 catheter blockage, 5 leakage, 4 migration and dislodgement). In the PICC group, 6 of 29 had complications (3 blockage, and 3 migration and dislodgement). There was, however, no statistically significant difference between the Hickman and PICC groups in terms of number of infections (p = 0.241), time to infection onset (p = 0.187), non-infectious complication rate (p = 0.101), and overall complication rate (p = 0.766).
Conclusion: With the less invasive nature of PICC insertion, it provides a viable means of vascular access for oncology patients.
中文摘要
癌症患者Hickman導管置入和外周中央靜脈導管置入感染率比較
王慧瑜、陳煥章、葉筱筠、吳詠淇、陳積聖、何凱文、蕭廣樂、陳崇文
目的：為癌症患者置入Hickman導管和外周置入中央靜脈導管（PICC），比較兩種方法的導管關聯的血液感染率和非感染性併發症的發生率。
方法：回顧研究2008年1月至2013年12月期間於香港一所分區醫院放射科接受Hickman導管或PICC置入的癌症患者。評估及比較兩組患者以下各項指標差異：導管相關性血液感染率、導管置入至感染發生的時間，以及非感染性併發症的發生率。
結果：研究期間，161名癌症患者接受Hickman導管置入，另29名患者接受PICC（共190例）。導管相關性血液感染病例，Hickman導管組有38例，PICC組4例；導管相關性血液感染率方面，導管留置1000天則整體感染率為1.364，Hickman導管組為1.340，PICC組則為1.654。至於非感染性併發症，Hickman導管組161名患者中有15例（導管堵塞6例、泄漏5例、移動及變位4例），PICC組29名患者中則有6例（堵塞3例、移動及變位3例）。兩組之間在以下幾方面均無統計學上的顯著差異：感染病例數目（p=0.241），導管置入至感染發生的時間（p=0.187），非感染性併發症發生率（p=0.101），併發症總體發生率（p=0.766）。
結論：微創性PICC置入是癌症患者一種建立血管通路的可行方法。