左心室辅助装置植入患者术后传动系统感染的影响因素分析及护理启示

doi:10.3761/j.issn.2096-7446.2025.12.007

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (12): 1454-1458.doi: 10.3761/j.issn.2096-7446.2025.12.007

• 心脏术后重症管理与康复 • 上一篇下一篇

左心室辅助装置植入患者术后传动系统感染的影响因素分析及护理启示

耿丹丹(), 孙国珍(), 管玉珍, 陈晴晴, 朱刘金, 刘思宇, 周娟, 沈燕萍

210000 南京市南京医科大学护理学院（耿丹丹，孙国珍）；南京医科大学第一附属医院心脏大血管外科（管玉珍，陈晴晴，朱刘金）；南京医科大学附属南京医院心胸血管外科（刘思宇）；东南大学附属中大医院心脏大血管外科（周娟）；复旦大学附属中山医院心脏大血管外科（沈燕萍）

收稿日期:2025-03-15 出版日期:2025-12-10 发布日期:2025-12-11
通讯作者: 孙国珍 E-mail:gengdandan1988@126.com;gzsun100@126.com
作者简介:耿丹丹：女，本科（硕士在读），护士长，E-mail：gengdandan1988@126.com
基金资助:
国家自然科学基金面上项目(72074124);江苏省科教能力提升工程(ZDXK202230);护理创新扶持工程护理研究课题(HLCXKT-20230180)

Analysis of influencing factors of driveline infection after left ventricular assist implantation and nursing enlightenment

GENG Dandan(), SUN Guozhen(), GUAN Yuzhen, CHEN Qingqing, ZHU Liujin, LIU Siyu, ZHOU Juan, SHEN Yanping

Received:2025-03-15 Online:2025-12-10 Published:2025-12-11
Contact: SUN Guozhen E-mail:gengdandan1988@126.com;gzsun100@126.com

摘要/Abstract

摘要：

目的探讨左心室辅助装置（left ventricular assist device，LVAD）植入术后传动系统感染（driveline infection，DLI）的影响因素，并提出针对性护理对策。方法回顾性选取2021年7月—2024年12月国内4所医疗中心的120例LVAD植入患者，通过一般资料调查表、自我护理能力评价量表修订版和家庭关怀指数问卷收集数据，采用二元Logistic回归分析DLI的影响因素。结果 DLI的发生率为19.17%（23/120）。单因素分析显示，糖尿病（OR=7.320，P<0.001）、低自我护理能力（OR=0.893，P<0.001）和低家庭关怀指数（OR=0.450，P<0.001）与DLI显著相关。多因素分析表明，糖尿病是DLI的独立危险因素（OR=6.050，P=0.003），家庭关怀指数为保护因素（OR=0.533，P=0.014）。结论 DLI的发生与糖尿病、自我护理能力及家庭支持密切相关。建议通过血糖控制、提升自我管理能力和家庭关怀程度，降低DLI的发生率。

关键词: 心脏辅助装置, 传动系统感染, 危险因素, 危重病护理

Abstract:

Objective To explore the influencing factors of driveline infection（DLI） after left ventricular assist device（LVAD） implantation，and put forward targeted nursing countermeasures. Methods A total of 120 patients with LVAD implantation from four medical centers in China from July 2021 to December 2024 were retrospectively selected. The data were collected by the general information questionnaire，the Appraisal of Self-care Agency Scale-Revised（ASAS-R-C） and the Family APGAR Index Questionnaire. Binary logistic regression was used to analyze the determinants of DLI. Results The incidence of DLI was 19.17%（23/120）. Univariate analysis showed that diabetes（OR=7.320，P<0.001），low self-care ability（OR=0.893，P<0.001） and low family care index（OR=0.450，P<0.001） were significantly correlated with DLI. Multivariate analysis showed that diabetes was an independent risk factor for DLI（OR=6.050，P=0.003），and family care index was a protective factor（OR=0.533，P=0.014）. Conclusion The occurrence of DLI is closely related to diabetes，self-care ability and family support. It is recommended to reduce the incidence of DLI by blood glucose control，improving self-management ability and family care.

Key words: Heart-Assist Device, Driveline Infection, Risk Factors, Critical Care Nursing

耿丹丹, 孙国珍, 管玉珍, 陈晴晴, 朱刘金, 刘思宇, 周娟, 沈燕萍. 左心室辅助装置植入患者术后传动系统感染的影响因素分析及护理启示[J]. 中华急危重症护理杂志, 2025, 6(12): 1454-1458.

GENG Dandan, SUN Guozhen, GUAN Yuzhen, CHEN Qingqing, ZHU Liujin, LIU Siyu, ZHOU Juan, SHEN Yanping. Analysis of influencing factors of driveline infection after left ventricular assist implantation and nursing enlightenment[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(12): 1454-1458.

图/表 3

参考文献 19

[1]	Mancini D, Colombo PC. Left ventricular assist devices:a rapidly evolving alternative to transplant[J]. J Am Coll Cardiol, 2015, 65(23):2542-2555. doi: 10.1016/j.jacc.2015.04.039 pmid: 26065994
[2]	Schlöglhofer T, Michalovics P, Riebandt J, et al. Left ventricular assist device driveline infections in three contemporary devices[J]. Artif Organs, 2021, 45(5):464-472. doi: 10.1111/aor.13843 pmid: 33052592
[3]	Aslam S, Cowger J, Shah P, et al. The international society for heart and lung transplantation(ISHLT):2024 infection definitions for durable and acute mechanical circulatory support devices[J]. J Heart Lung Transplant, 2024, 43(7):1039-1050. doi: 10.1016/j.healun.2024.03.004
[4]	Hannan MM, Xie RB, Cowger J, et al. Epidemiology of infection in mechanical circulatory support:a global analysis from the ISHLT Mechanically Assisted Circulatory Support Registry[J]. J Heart Lung Transplant, 2019, 38(4):364-373. doi: 10.1016/j.healun.2019.01.007
[5]	Qu Y, Peleg AY, McGiffin D. Ventricular assist device-specific infections[J]. J Clin Med, 2021, 10(3):453. doi: 10.3390/jcm10030453
[6]	王雪皎, 朱懿珍, 谢霞, 等. 心力衰竭患者左心室辅助装置传动系统感染的研究进展[J]. 中国感染控制杂志, 2022, 21(4):404-408.
	Wang XJ, Zhu YZ, Xie X, et al. Research progress on left ventricular assist device driveline infection in pa-tients with heart failure[J]. Chin J Infec Contl, 2022, 21(4):404-408.
[7]	刘延锦, 余溯源, 郭丽娜, 等. 汉化修正版自我护理能力评估量表用于成年人群中的信效度研究[J]. 重庆医学, 2018, 47(33):4266-4269.
	Liu YJ, Yu SY, Guo LN, et al. Study on reliability and validity of Chinese edition of appraisal of self-care ability rating scale revised among adults[J]. Chongqing Med, 2018, 47(33):4266-4269.
[8]	McLachlan GJ, Bean RW, Peel D. A mixture model-based approach to the clustering of microarray expression data[J]. Bio-informatics, 2002, 18(3):413-422.
[9]	Varshney AS, DeFilippis EM, Cowger JA, et al. Trends and out-comes of left ventricular assist device therapy:JACC focus seminar[J]. J Am Coll Cardiol, 2022, 79(11):1092-1107. doi: 10.1016/j.jacc.2022.01.017 pmid: 35300822
[10]	Wang XQ, Zhou XT, Chen HB, et al. Long-term outcomes of a novel fully magnetically levitated ventricular assist device for the treatment of advanced heart failure in China[J]. J Heart Lung Transplant, 2024, 43(11):1806-1815. doi: 10.1016/j.healun.2024.05.004
[11]	Shah P, Birk SE, Cooper LB, et al. Stroke and death risk in ventricular assist device patients varies by ISHLT infection category:an INTERMACS analysis[J]. J Heart Lung Transplant, 2019, 38(7):721-730. doi: 10.1016/j.healun.2019.02.006
[12]	张昊天, 周星彤, 尹泽琳, 等. 左心室辅助装置植入术后神经系统并发症及相关因素分析[J]. 中国循环杂志, 2025, 40(4):359-366.
	Zhang HT, Zhou XT, Yin ZL, et al. Analysis of the neurological complications and related factors after left ventricular assist device implantation[J]. Chin Circul J, 2025, 40(4):359-366.
[13]	Köhler AK, Körperich H, Morshuis M, et al. Pre-operative risk factors for driveline infection in left ventricular-assist device patients[J]. ESC Heart Fail, 2022, 9(6):3995-4002.
[14]	Holt RIG, Cockram CS, Ma RCW, et al. Diabetes and infection:review of the epidemiology,mechanisms and principles of treatment[J]. Diabetologia, 2024, 67(7):1168-1180. doi: 10.1007/s00125-024-06102-x
[15]	张艳, 徐蓉, 刘芳, 等. 糖尿病管理中护士的角色发展及展望[J]. 中华护理教育, 2023, 20(9):1038-1044.
	Zhang Y, Xu R, Liu F, et al. The development and prospect of the role of nurses in diabetes management in China[J]. Chin J Nurs Edu, 2023, 20(9):1038-1044.
[16]	朱旭菁, 陈霞, 黄翱黎, 等. 左心室辅助装置植入患者心理护理的研究进展[J]. 中华急危重症护理杂志, 2023, 4(9):860-864.
	Zhu XJ, Chen X, Huang GL, et al. Research progress in psychological nursing of patients with left ventricular assist device implantation[J]. Chin J Emerg Crit Care Nurs, 2023, 4(9):860-864.
[17]	邱小芩, 黄彩献, 傅桂芬, 等. 慢性心力衰竭患者院外健康管理程序的构建及应用[J]. 中华护理杂志, 2022, 57(4):401-407. doi: 10.3761/j.issn.0254-1769.2022.04.003
	Qiu XQ, Huang CX, Fu GF, et al. Construction and application of APP in out-of-hospital health management for patients with chronic heart failure[J]. Chin J Nurs, 2022, 57(4):401-407. doi: 10.3761/j.issn.0254-1769.2022.04.003
[18]	Pavlovic NV, Randell T, Madeira T, et al. Risk of left ventricular assist device driveline infection:a systematic literature review[J]. Heart Lung, 2019, 48(2):90-104. doi: S0147-9563(18)30340-6 pmid: 30573195
[19]	宓龙, 刘翠, 张丽, 等. 左心室辅助装置植入术后患者自我管理的最佳证据总结[J]. 护理学杂志, 2024, 39(21):45-50.
	Mi L, Liu C, Zhang L, et al. Evidence summary on self-management in patients receiving left ventricular assist device implantation[J]. J Nurs Sci, 2024, 39(21):45-50.

左心室辅助装置植入患者术后传动系统感染的影响因素分析及护理启示

Analysis of influencing factors of driveline infection after left ventricular assist implantation and nursing enlightenment

RichHTML

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

图/表 3

参考文献 19

相关文章 15

编辑推荐

Metrics

本文评价

[1]	祖路比亚·阿布都, 李婷, 孙丽冰, 陈慧娟. 多发伤患者深静脉血栓形成风险预测模型的构建及验证研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1067-1073.
[2]	肖倩云, 黄晓霞, 周鑫滢, 叶欢, 周丽萍. 极重度肥胖伴肺栓塞患者的多学科协作护理[J]. 中华急危重症护理杂志, 2025, 6(9): 1094-1096.
[3]	王园, 吴慧玲, 邵乐文. 妊娠合并心脏病患者健康相关生活质量影响因素及评估工具的研究进展[J]. 中华急危重症护理杂志, 2025, 6(9): 1149-1152.
[4]	李力, 王晓安, 吴轲, 张志泉, 吴丽芬. 肠系膜巨大淋巴管瘤致短肠综合征患儿行小肠移植的术后护理[J]. 中华急危重症护理杂志, 2025, 6(9): 1103-1105.
[5]	王婷婷, 马亚君, 高雯, 张玉萍, 金静芬. 家属声音刺激预防ICU谵妄的研究进展[J]. 中华急危重症护理杂志, 2025, 6(8): 1017-1020.
[6]	刘宇亭, 祁梦莹, 蒙斯雅, 王冰寒, 王乔莎, 何桂兰. 成人体外膜肺氧合镇痛镇静管理方案的构建及应用效果研究[J]. 中华急危重症护理杂志, 2025, 6(8): 901-907.
[7]	汪依佳, 潘爱红, 刘芮, 陈倩, 王铖琛. ICU患者家属创伤后应激障碍影响因素的Meta分析[J]. 中华急危重症护理杂志, 2025, 6(8): 938-944.
[8]	张晶, 王丽竹, 黄晓霞, 封秀琴. 重度肥胖患者严重创伤后合并急性呼吸窘迫综合征的护理[J]. 中华急危重症护理杂志, 2025, 6(8): 957-959.
[9]	羊木英, 陈轩, 胡汉. 声门下气道重度狭窄患者血液透析时突发气道梗阻的急救护理[J]. 中华急危重症护理杂志, 2025, 6(8): 960-963.
[10]	王琴, 王飞霞, 王群敏, 姜蝶, 潘喆, 李卫珍, 赵盼盼, 华汉巨. 肠外瘘患者行瘘口内插管转流技术的护理[J]. 中华急危重症护理杂志, 2025, 6(8): 964-966.
[11]	邹双, 宋剑平, 陈海莲, 郑琳琳. 急性心肌梗死伴血糖正常型糖尿病酮症酸中毒合并脑出血患者的护理[J]. 中华急危重症护理杂志, 2025, 6(7): 843-845.
[12]	谢仕龙, 卢芳燕. Ⅰ型瓜氨酸血症患儿肝移植术后并发乳糜漏的护理[J]. 中华急危重症护理杂志, 2025, 6(7): 850-852.
[13]	胡明强, 刘颖, 刘琪燕, 郑梦珂, 李珊珊, 余晶晶, 张妙琪, 孙家安. “1 h创伤急救圈”信息交互系统在严重创伤患者救治中的应用研究[J]. 中华急危重症护理杂志, 2025, 6(6): 681-686.
[14]	卢露, 卢芳燕, 朱莉. 肺移植术后并发急性肢体缺血患者的护理[J]. 中华急危重症护理杂志, 2025, 6(6): 697-699.
[15]	杨琳, 李峥嵘, 徐玉婷. 输卵管卵巢炎症致重症盆腹腔脓肿患者的护理[J]. 中华急危重症护理杂志, 2025, 6(6): 704-706.