胃肠道肿瘤患者经外周静脉置入中心静脉导管相关性血栓的危险因素及对策分析

Investigation of risk factors and strategy of peripherally inserted central catheters-related thrombosis in gastroenteric tumor patients

目的探讨胃肠道肿瘤患者经外周静脉置入中心静脉导管相关性血栓的危险因素,并提出预防策略措施。方法对2 450例行经外周静脉置入中心静脉置管的胃肠道肿瘤患者进行回顾性调查,依据患者置管期间是否发生导管相关性血栓将其分为血栓组(87例)和非血栓组(2 363例);分析胃肠道肿瘤患者经外周静脉置入中心静脉导管相关性血栓的发生率;采用单因素法和多因素logistic回归法筛选影响静脉血栓的危险因素。结果胃肠道肿瘤患者经外周静脉置入中心静脉导管相关性血栓的发生率为3.55%(87/2 450);多因素logistic回归分析结果显示,影响导管相关性血栓的危险因素包括高龄(OR=1.895)、静脉血栓史(OR=4.860)、感染(OR=5.737)、未预防使用抗凝药物(OR=2.670)、活化部分凝血活酶时间水平低(OR=3.219)、导管相关并发症(OR=4.225)等。结论胃肠道肿瘤患者经外周静脉置入中心静脉导管,导管相关性血栓的发生率较高,其危害也较大。应针对以上高危因素,早期预防性评估,并及时采取预防措施,降低静脉血栓的发生率。

Objective To explore the risk factors and strategy of peripherally inserted central catheters-related thrombosis in gastroenteric tumor patients.Methods Totally 2 450 gastroenteric tumor patients with peripherally inserted central catheters were included in this retrospective study which were divided into two groups,the thrombosis group(87 cases)and the non-thrombosis group(2 363)according to whether the catheter-related thrombosis happened or not during the catheter indwelling time.The risk factors of peripherally inserted central catheters-related thrombosis in gastroenteric tumor patients were analyzed with univariate analysis and multi-factor Logistic regression analysis.Results The incidence rate of peripherally inserted central catheters-related thrombosis in gastroenteric tumor patients was 3.5%(87/2 450).Multiple factors Logistic regression method showed that the risk factors of catheter-related thrombosis included advanced age(OR=1.895),history of venous thrombosis(OR=4.860),infection(OR=5.737),without the use of preventive anticoagulant drugs(OR=2.670),shortened time of activated partial thromboplastin(OR=3.219)and catheter related complications(OR=4.225).Conclusion Gastroenteric tumor patients with peripherally inserted central catheters have a relatively high incidence rate of catheter-related thrombosis which is with great harm for patients.We should carry out preventive assessment and preventive measures in time to reduce the incidence rate of peripherally inserted central catheters-related thrombosis aimed at the risk factors.