成人无症状导管相关血栓形成后无抗凝治疗对其预后影响研究

Study on the prognosis of asymptomatic catheter-related thrombosis in adults without anticoagulant therapy

目的探讨无症状导管相关血栓形成(CRT)后不进行抗凝治疗对患者预后的影响。方法回顾性分析2017年9月至2019年1月该院收治的357例成人无症状CRT患者的临床资料,包括年龄、血栓体积、D-二聚体水平、超声结果、并发症及随访情况。对患者诊断时、拔出导管前血栓体积、D-二聚体水平进行统计学比较。结果在357例患者中,有43例患者在确诊无症状CRT时即拔出导管,剩余314例患者在导管留置期间,1例意外发现发生无症状性肺栓塞,5例并发导管相关血流感染,3例发生导管阻塞。302例未经抗凝治疗的无症状CRT患者血栓体积、D-二聚体水平较诊断时均有下降,且差异均有统计学意义(P<0.05)。拔管后3月,无一例随访患者发生明显深静脉血栓形成后综合征。结论CRT发生后,未经抗凝治疗患者的血栓体积及D-二聚体水平可自行下降,且无抗凝治疗对患者预后无明显不良影响。

Objective To explore the Influence for prognosis of patients with asymptomatic catheter-related thrombosis(CRT)without anticoagulation therapy.Methods The clinical data of 357 adult asymptomatic CRT patients admitted to the hospital from September 2017 to January 2019 were retrospectively analyzed,including age,thrombus volume,D-dimer level,ultrasound results,complications and follow-up.The thrombus volume and D-dimer level of at the time of diagnosis and before catheter removal were statistically compared.Results Among the 357 patients,43 patients pulled out the catheter when asymptomatic CRT was diagnosed.In the remaining 314 patients,asymptomatic pulmonary embolism was accidentally found in 1 patient,catheter-related blood flow infection occurred in 5 patients,and catheter blockage occurred in 3 patients.The thrombus volume and D-dimer levels of the resting 302 patients without anticoagulant therapy were significantly lower than those at the time of diagnosis,the differences were statistically significant(P<0.05).3 months after extubation,no follow-up patient developed obvious post-deep vein thrombosis syndrome.Conclusion After the occurrence of CRT,the thrombus volume and D-dimer level of patients without anticoagulant trerapy can decrease spontaneously,and there is no obvious adverse effect on the prognosis of patients.