肿瘤患者行PICC置管后伴发静脉血栓的原因分析及护理干预

Analysis of the Causes of Venous Thrombosis and Nursing Intervention in Patients With Tumor After PICC Catheterization

目的研究分析肿瘤患者通过外周静脉穿刺中心静脉置管(PICC)后静脉血栓发作的原理,并探讨研究静脉血栓的医护方式。方法对于2013年1月—2015年4月于本科室住院的198例行PICC置管的肿瘤患者中并发静脉血栓11例的实际医护数据的回顾。结果在本组的198例肿瘤患者中,PICC置管后同时患有静脉血栓的患者有11例,比率为5.56%;11例同时发作的静脉血栓患者中,肺癌有5例,乳腺癌有2例,食管癌2例和胃癌2例,其中拆除PICC管的占7例,其他的4例在经过抗凝、祛聚和降纤治疗手段后有好转,所以放弃拔出PICC管。结论高凝状态、化疗药物和置管等因素可能是肿瘤患者在PICC置观管后同时发生静脉血栓的主要原因,开展预见性的评估和预测静脉血栓出现,提早加入抗凝、祛聚药物及其合理的护理干预等措施可以极大限度的减少静脉血栓的出现。

Objective To analyze the principle of venous thrombosis after peripheral vein puncture of central venous catheter(PICC)in patients with tumor and to explore the methods of medical care for venous thrombosis.Methods A retrospective review of actual medical data on 198 patients with PICC catheterized tumors who had venous thromboembolism in 198 patients hospitalized in our department from January 2013 to April 2015 was conducted.Results Of the 198 patients with cancer who underwent PICC,there were 11 patients with venous thrombosis after catheterization at a rate of 5.56%.Of 11 patients with concurrent venous thrombosis,5 cases had lung cancer and 2 cases had breast cancer.2 cases of esophageal cancer and 2 cases of gastric cancer,including removal of PICC tube accounted for 7 cases,the other 4 cases after anticoagulant,removal and fibrinolytic therapy has improved,so give up pull out PICC tube.Conclusion Hypercoagulability,chemotherapeutic drugs and catheterization may be the main causes of venous thrombosis in the tumor patients after PICC catheterization.Carrying out foreseeable assessment and prediction of venous thrombosis,early addition of anticoagulant,dispelling drug and reasonable nursing intervention can reduce the appearance of venous thrombosis to a great extent.