关于PICC置管后上肢静脉血栓形成的分析

Incidence of Upper Limb Venous Thrombosis Associated with Peripherally Inserted Central Catheters

目的笔者研究患者在置入经外周静脉穿刺中心静脉导管(PICC管)后,上肢静脉血栓形成的发生率,并分析静脉血栓形成的各种可能原因。方法在2007年7月-2012年1月于普外科住院的患者中,选择55例成功接受PICC管置入的患者,其中置管目的为肠外营养的30例(54.5%),长期使用抗生素的13例(23.6%),使用化疗药物的12例(21.8%)。结果所有选择的病例都成功的置入了PICC管,PICC管的平均留置时间是13 d(留置时间最短的为1d,最长的为136 d),发生静脉血栓形成的有15例(27.3%),其中为完全性闭塞的11例(20.0%);静脉血栓形成的发生与患者年龄、性别及有无吸烟史等临床病例特征无明确相关性。结论 PICC是一种简单、安全、有效的静脉穿刺方式,但是可引起上肢静脉血栓等相应的并发症。

Objective To study the occurrence of venous thrombosis（VT） in the upper limbs of patients undergoing peripherally inserted central catheters（PICC）,and analyze every possible cause of venous thrombosis.Methods The clinical data of 55 patients undergoing PICC placement from July,2007 to January,2012 in our department were analyzed.A total of 61 PICC lines were placed in 55 patients for TPN（n=30）,long-term antibiotics（n=13）,chemotherapy（n=10）.Results All PICC lines were successfully inserted.PICC lines were used for a mean duration of 13 days（1-136 days）.The occurrence of venous thrombosis and complete occlusive thrombi were 27.3% and 20%,respectively.There was no statistical correlation between the occurrence of VT with the patient＇s ages,sex,and smoking experience.Conclusion PICC lines are a simple,safe and effective alternative to conventional central venous catheters.However,PICCs are associated with a significant risk of upper extremity deep vein thrombosis（UEVT）.