实体肿瘤与急性白血病患者PICC置管并发症差异分析

Analysis of the difference complication of peripherally inserted central catheters with solid tumor and acute leukemia patients

目的:比较实体肿瘤与急性白血病患者行经外周静脉留置中心静脉导管(peripherally inserted central catheter,PICC)并发症发生率的差异,为更好的应用于患者提供治疗策略。方法:选取保定市第一医院2009年8月至2015年6月100例实体肿瘤与100例急性白血病化疗行PICC置管患者,观察两组PICC置管后并发症及其发生率,探讨实体肿瘤患者与急性白血病PICC并发症的不同。结果:急性白血病PICC置管后并发症总发生率为39.0%,明显高于实体肿瘤患者26.0%,χ2=3.85,P<0.0 5。其中静脉炎发生率2 7.0%v s.2 3.0%,χ2=0.4 3,P>0.0 5;感染发生率2 1.0%v s.1 0.0%,χ2=4.62,P<0.05;血栓发生率15.0%vs.23.0%,χ2=2.28,P>0.05;导管堵塞发生率11.0%vs.13.0%,χ2=0.19,P>0.05;出血发生率16.0%vs.3.0%,χ2=9.83,P<0.01。血常规参数显示,急性白血病组出现感染并发症时白细胞明显低于实体肿瘤组,出现血栓时白细胞明显高于实体肿瘤组,出现出血时血小板明显低于实体肿瘤组。结论:PICC置管后急性白血病患者与实体肿瘤患者各种并发症发生率存在差异,可能与血常规参数密切相关。

Objective： To compare the difference complication of peripherally inserted central catheters（PICC） with solid tumor and acute leukemia patients in order to provide a better treatment strategies in patients with application. Methods： A total of 100 cases of solid tumors and 100 cases of acute leukemia patients with PICC before chemotherapy were selected from August 2009 to June 2015. The incidence of the difference complications of PICC with solid tumors and acute leukemia were observed. Results： The complication rate was 39.0% in acute leukemia after PICC, significantly higher than that of solid tumors 26.0%, χ2=3.85, P〈0.05. The incidence of phlebitis was 27.0% vs. 23.0%, χ2=0.43, P〉0.05; the infection rate was 21.0% vs. 10.0%, χ2=4.62, P〈0.05; thethrombosis rate was 15.0% vs. 23.0%, χ2=2.28, P〉0.05; the incidence of catheter blockage was 11.0% vs. 13.0%, χ2=0.19, P〈0.05; the bleeding rate was 16.0 % vs. 3.0%, χ2=9.83, P〈0.01. Blood parameters showed that the white blood cells in acute leukemia group were significantly lower than that of solid tumor with infectious complications; the white blood cells in acute leukemia group were significantly higher than that group of solid tumors with thrombosis, the platelets in acute leukemia group were significantly lower than that in solid tumors with bleeding. Conclusion： The complication rate of acute leukemia and solid tumor patients with PICC was different, which may closely related to blood routine parameters.