恶性肿瘤患者PICC相关性血栓的危险因素及护理策略分析

Analysis of Risk Factors and Nursing Strategies of PICC Associated Thrombus in Patients with Malignant Tumor

目的探讨恶性肿瘤患者PICC相关性血栓的危险因素及相应护理策略。方法回顾性分析2017年10月至2019年9月于锦州医科大学附属第一医院行PICC置管的恶性肿瘤患者228例为研究对象,分析其发生静脉血栓的危险因素。根据其相关危险因素,将2019年10月至2020年10月于我院行PICC置管,符合纳入标准的124例患者随机分为常规护理组和护理干预组,各62例,比较两组患者术后14 d内静脉血栓的发生率。结果回顾分析于我院行PICC的恶性肿瘤患者228例,其中发生血栓患者31例(13.4%)。对单因素有意义的变量进行赋值,代入非条件Logistic回归模型,发现年龄≥60岁、BMI≥25、肿瘤分期Ⅲ~Ⅳ期、既往血栓病史、伴有基础疾病、置管前D-二聚体>0.5 mg/L为恶性肿瘤患者PICC相关性血栓发生独立危险因素(P<0.05);常规护理组发生静脉血栓患者10例(16.13%),护理干预组发生静脉血栓4例(6.45%),两组比较差异有统计学意义(P<0.05)。结论恶性肿瘤患者PICC相关性血栓的发生与患者年龄、BMI、肿瘤分期、血栓病史、基础疾病情况、置管前D-二聚体含量密切相关,通过临床护理干预可降低恶性肿瘤患者PICC相关性血栓的发生率。

Objective To explore the risk factors and nursing strategies of PICC-related thrombus in patients with malignant tumor.Methods A retrospective analysis was performed on 228 patients with malignant tumor who underwent PICC catheterization in the First Affiliated Hospital of Jinzhou Medical University from October 2017 to September 2019,and the risk factors of venous thrombosis were analyzed.According to the relevant risk factors,124 patients who received PICC catheterization in our hospital from October 2019 to October 2020 and met the inclusion criteria were randomly divided into the routine care group and the nursing intervention group(62 patients each),and the incidence of venous thrombosis within 14 days after surgery was compared between the two groups.Results A retrospective analysis was performed on 228 patients with malignant tumor who underwent PICC in our hospital,including 31 patients(13.4%)with thrombus.For single factor meaningful variable assignment,plug in unconditioned Logistic regression model,found that age 60 years or more,a BMI of 25 or more,tumor stagingⅢ~Ⅳperiod,history,with underlying disease,catheter thrombosis before D-dimer>0.5 mg/L usm correlation thrombosis occurs for malignant tumor patients independent risk factors(P<0.05);There were 10 patients(16.13%)in the routine nursing group and 4 patients(6.45%)in the nursing intervention group,with statistically significant difference between the two groups(P<0.05).Conclusion The occurrence of PICC-related thrombi in patients with malignant tumors is closely related to age,BMI,tumor stage,history of thrombi,underlying diseases,and d-dimer content before catheterization.Clinical nursing intervention can reduce the incidence of PICC-related thrombi in patients with malignant tumors.