老年住院患者经外周静脉穿刺中心静脉置管相关深静脉血栓危险因素分析

Risk factors analysis of peripherally inserted central catheter-related deep venousthrombosis in elderly inpatients

目的分析老年住院患者经外周静脉穿刺中心静脉置管(PICC)相关深静脉血栓形成(PICC-DVT)的危险因素。方法选取行上肢PICC置管的老年住院患者564例,PICC术后发生上肢深静脉栓塞的141例为PICC-DVT组,未发生上肢深静脉血栓的423例为对照组。通过回顾性分析两组患者临床数据,探讨老年住院患者PICC-DVT的相关危险因素。结果老年住院患者PICC-DVT发生率为25%;多因素Logistic回归分析显示:心房颤动(OR=2.15,95%CI:1.298~3.433),动脉粥样硬化(OR=2.72;95%CI:1.715~4.372),置管期间手术史(OR=3.23,95%CI:1.358~7.584),静脉血栓史(OR=7.68,95%CI:4.513~13.311),是老年住院患者PICC-DVT的独立危险因素。结论老年住院患者是PICC-DVT的高危人群,心房颤动、动脉粥样硬化、置管期间手术史、静脉血栓史是PICC-DVT的独立危险因素。

Objective To analyze the risk factors of upper extremity deep venous thrombosis in elderly inpa-tients following peripherally inserted central catheter （ PICC ） . Methods A total of 564 elderly inpatients following PICC enrolled were divided into upper extremity deep venous thrombosis group（ n = 141） and control group（ n = 423 ） . All the clinical data was retrospectively analyzed by the use of univariate and multivariate logistic regression analysis to explore the risk factors with the elderly inpatients. Results Upper extremity deep vein thrombosis occurred in 141 （25% ） out of the 564 patients. Multivariatelogistic regression analysis revealed that atrial fibrillation（ OR - 2. 15 ,95% CI：／. 298 - 3. 433 ） , atherosclerosis （ OR = 2 .1 2 ,95% Cl ： ／ .115 - 4 . 372） , surgery longer than 1 h during dwell time of the catheter（ OR = 3. 23,95% Cl： 1. 358 - 7. 584 ） and history of deep vein thrombosis （ OR = 7. 6 8 ,95% Cl： 4. 513 - 13. 311） were the independent risk factors for the PICC-DVT in elderly inpatients. Conclusions Elderly pa-tients are under high risk state of PICC-DVT. Atrial fibrillation, atherosclerosis, surgery longer than lh during dwell time of the catheterand history of deep vein thrombosis are the independent risks factors for PICC-DVT in elderly inpa-tients.