重症肺炎患者深静脉穿刺置管术后管腔内血栓形成相关因素分析

Analysis of the relevant factors of intraductal thrombosis after deep venous catheterization

目的探讨深静脉穿刺术后管腔内血栓形成相关因素。方法选取在急诊重症监护室(EICU)住院凝血功能正常的深静脉穿刺置管重症肺炎患者19例,术前抽血测定C-反应蛋白(CRP)、D-二聚体(D-Dimer)、血小板计数(PLT)、凝血酶原时间(PT)、激活部分凝血活酶时间(APTT),置管>48 h入组,拔管后肉眼判断管腔内是否有血栓形成,有则送病理检验,同时抽血查CRP、D-Dimer、PLT、PT、AP[T。统计分析深静脉置管前后的检验结果,分析深静脉置管前后血栓形成的相关因素。结果 19例发生深静脉导管内混合血栓。深静脉穿刺置管术前后CRP、D-Dimer、PT和PLT比较差异均有统计学意义(P<0.05或P<0.01);APTT置管前后比较差异无统计学意义(P>0.05)。结论 PT、CRP、D-Dimer和PLT可作为监测深静脉穿刺置管术后导管内血栓形成的重要指标。

Objective To investigate the relevant factors of intraduetal thrombosis after deep venous catheterization. Methods Nineteen seriously ill patients with normal coagulation function in EICU of the people ＇ s Hospital of Guangxi Zhuang Autonomous Region were chosen. CRP, D-Dimer, PLt, PT, APTT were test before Deep venipuncture and after 48 hours. The deep venous catheters were pulled out and the intraduetal thromboses were tested by pathological examination after 48 hours of deep venous catheterization. All the test results and the relevant factors of intraductal thrombosis after deep venous catheters were inserted were statistically analyszed. Results Nineteen cases intraductal thrombosis were found after deep venous catheters were inserted. In the test result of CRP, D-Dimer,PLT, PT, there were statistically significant differenee before and after deep venous venipuneture （P 〈 0. 05）. Conclusion The test of CRP,D-Dimer,PLt,PT can be used for monitoring the occurrence of intraduetal thrombosis in deep venipuncture.