直肠癌肝转移输液港植入患者导管相关性血栓影响因素分析

Analysis of Influencing Factors of Catheter-related Thrombosis in Patients with Rectal Cancer Implanted in the Infusion Port with Liver Metastasis

目的:分析直肠癌肝转移输液港植入患者发生导管相关性血栓的影响因素,为后期临床预防导管相关性血栓发生的早期筛查及干预计划制定提供依据。方法:回顾性分析510例直肠癌肝转移输液港植入患者临床资料,根据是否发生导管相关性血栓将其分为发生组和未发生组,纳入可能影响因素,设计一般情况调查问卷,经单因素与多因素分析直肠癌肝转移输液港植入患者发生导管相关性血栓的影响因素。结果:本组32例(6.27%)患者发生导管相关性血栓。经单因素与多项Logistic回归分析检验结果显示,植入式静脉输液港(IVAP)局部及血流感染、导管继发异位、穿刺左上肢、肠外营养、美国东部肿瘤协作组(ECOG)评分、体质指数(BMI)均可能是诱发直肠癌肝转移输液港植入患者发生导管相关性血栓的影响因素(P<0.05,P<0.01)。结论:直肠癌肝转移输液港植入患者发生导管相关性血栓受多种因素共同影响,如IVAP局部及血流感染、导管继发异位、穿刺左上肢、肠外营养、ECOG评分、BMI均是影响因素,因此,临床管理者应注重进行早筛查和早干预。

Objective:To analyze the influencing factors of catheter-related thrombosis in patients with rectal cancer implanted in the infusion port with liver metastasis,so as to provide the basis for early screening and intervention planning for the prevention of catheter-related thrombosis in the later clinical stage.Methods:a retrospective analysis of 510 patients of rectal cancer liver metastases with infusion port was conducted.They were divided into two groups according to whether catheter-related thrombosis occurred or not,which was included in possible influencing factors.A general condition questionnaire was designed to analyze the influencing factors of catheter-related thrombosis in patients with rectal cancer implanted in the infusion port with liver metastasis through single and multiple factors.Results:Catheter-related thrombosis occurred in 32 patients(6.27%).Single factor and multiple Logistic regression analysis of test results showed that the Implantable Venous Access Port(IVAP)local and bloodstream infections,ectopic,puncture of left upper limb,parenteral nutrition,Eastern Cooperative Oncology Group(ECOG)score,and body mass index(BMI)may be the influencing factors for the occurrence of catheter-related thrombosis in patients implanted with rectal cancer with liver metastasis and infusion port(P<0.05,P<0.01).Conclusion:The occurrence of catheter-related thrombosis in patients with rectal cancer implanted in the infusion port with liver metastasis is affected by multiple factors,such as local IVAP and bloodstream infection,secondary ectopic catheterization,puncture of the left upper limb,parenteral nutrition,ECOG score,and BMI.Therefore,clinical managers should pay attention to early screening and intervention.