慢性意识障碍患者PICC相关上肢静脉血栓形成的危险因素分析

Risk factor analysis of PICC-related upper extremity venous thrombosis in patients with chronic disorder of consciousness

目的分析慢性意识障碍(DOC)患者经外周置入中心静脉导管(PICC)后发生PICC相关上肢静脉血栓的危险因素,为预防及降低其发生提供参考依据。方法选取2019年1月至2020年12月解放军总医院第六医学中心高压氧科要求PICC置管治疗的127例慢性DOC患者。按照是否发生上肢静脉血栓,将其分为血栓组(n=26)和非血栓组(n=101)。分析2组患者的临床资料,对PICC相关上肢静脉血栓的危险因素进行统计学分析。结果单因素分析结果显示,D-二聚体、血PICC置管史、单次置管穿刺次数对慢性DOC患者PICC相关上肢静脉血栓的形成有明显影响(P<0.05)。Logistic多因素回归分析显示,D-二聚体、PICC置管史、单次置管穿刺次数是慢性DOC患者PICC相关上肢静脉血栓形成的危险因素(P<0.05)。结论对存在PICC相关上肢静脉血栓危险因素的慢性DOC患者进行针对性干预措施,可降低其发生率。

Objective To explore the risk factors of peripherally inserted central catheter(PICC)-related upper extremity venous thrombosis(UEVT)in patients with chronic disorder of consciousness(DOC)for preventing and reducing the occurrence of UEVT.Methods A total of 127 chronic DOC patients with PICC placement treated in the Department of Hyperbaric Medicine of the Sixth Medical Center of PLA General Hospital from 2019 January to 2020 December were selected and divided into UEVT group(n=26)and non-UEVT group(n=101)depending on whether the patients were suffering from UEVT.Potential risk factors were analyzed statistically using the clinical data of the patients in the two groups.Results The univariate logistic analysis showed that the D-dimer,catheterization history,and puncture times within one single catheterization had a significant impact on the formation of UEVT in chronic DOC patients with PICC placement(P<0.05).The multivariate logistic regression showed that the above factors were the risk factors in the formation of UEVT in chronic DOC patients with PICC placement(P<0.05).Conclusion Targeted precautionary intervention on chronic DOC patients with PICC placement can reduce the incidence of UEVT.