低相对分子质量肝素联合护理干预预防肿瘤患者PICC置管后深静脉血栓形成

The Clinical Study of Nursing Intervention Combined with Low Molecular Weight Heparin in Preventing Deep vein Thrombosis of Patients with Tumour after PICC Intubation

目的对经外周静脉置入中心静脉导管(PICC)术后深静脉血栓(DVT)发生规律进行相关探讨,同时探究低相对分子质量肝素(LMWH)对肿瘤患者PICC置管后深静脉血栓的预防效果。方法选择2014年3月至2016年10月期间600例PICC置管术后患者DVT的发生情况进行统计分析,并统计观察期间PICC置管术后发生DVT的患者使用LMWH并进行护理干预后深静脉血栓复发情况,将同期PICC置管术后未应用LMWH的患者设为对照组,并进行比较。结果 PICC置管术后DVT发生率为7.00%,其与伴糖尿病或高血压、冠心病、感染、长期卧床、D二聚体增高有明显的关系;应用LMWH后,PICC置管术后发生DVT的患者深静脉血栓发生率为0.00%,PICC置管术后未应用过LMWH的患者DVT发生率为7.00%,差异显著(P<0.05)。结论肿瘤患者PICC置管后发生DVT概率较高,其与伴糖尿病或高血压、冠心病、感染、长期卧床、D二聚体增高有明显的关系;通过LMWH的使用以及积极的护理干预能对DVT的发生率进行显著的减少,同时具有很高的安全性。

Objective Investigate the incidence of deep vein thrombosis （DVT） peripherally inserted central catheter （PICC） after operation and explore the preventive effect of low molecular weight heparin （LMWH） and nursing. Methods Given 600 cases of patients the retrospective analysis of occurrence of DVT after PICC intubation in our hospital from March 2014 to October 2016 Counted the recurrence of DVT in patients after using LMWH during the observation period of post-PICC intubation. Grouped the patients who were not treated with LMWH during the same observation period of post-PICC intubation into the control group and compared them. Results The incidence rate of DVT after PICC intubation was 7.00%, which had obvious relationship with the diabetes ,hypertension, coronary disease, infection ,long-term bed and the increase of D-dimer. After using LMWH, the recurernce rate of DVT in patients after PICC intubation was 0. 00%. Without using LMWH, the recurernce rate of DVT in patients after PICC intubation was 7.00%. There was significant difference in two groups （ P 〈 0.05 ）. The differences in two groups were statistical significance. Conclusion The incidence rate of DVT in patients with turnout after PICC intubation is higher, which had obvious relationship with diabetes, hypertension, coronary disease, infection, long- term bed and the increase of D-dimer. The use of LMWH can significantly reduce the incidence rate of DVT and it has high security at the same time.