淋巴瘤化疗患者经外周静脉置入中心静脉导管相关性静脉血栓的危险因素分析

Risk factors for venous thrombosis associated with peripherally inserted central catheters in lymphoma patients undergoing chemotherapy

目的探讨淋巴瘤化疗患者经外周静脉置入中心静脉导管(PICC)相关性静脉血栓的危险因素。方法采用便利抽样法, 选取2019年9月—2020年9月新乡市中心医院肿瘤内科收治的135例淋巴瘤化疗患者为研究对象, 根据是否发生PICC相关性静脉血栓将其分为血栓组(n=23)、非血栓组(n=112)。收集患者的一般资料、PICC置管静脉、导管尖端位置、PICC置管肢体等数据, 采用二项Logistic回归分析对PICC相关性静脉血栓的危险因素进行分析。结果淋巴瘤化疗患者PICC相关性静脉血栓的发生率为17.04%(23/135)。二项Logistic回归分析显示, 置管静脉为头静脉、导管尖端位置在上腔静脉上2/3内、导管直径/静脉直径比值≥67%是淋巴瘤化疗患者PICC相关性静脉血栓形成的独立危险因素(P<0.01)。结论淋巴瘤化疗患者发生PICC相关性静脉血栓的危险因素主要包括置管静脉为头静脉、导管尖端位置在上腔静脉上2/3内、导管直径/静脉直径比值≥67%。护理人员应重点关注高危人群, 积极采取干预措施, 以降低PICC相关性静脉血栓的发生率。

Objective To investigate the risk factors of venous thrombosis associated with peripherally inserted central catheter(PICC)in lymphoma patients undergoing chemotherapy.Methods Using the convenient sampling method,a total of 135 patients with lymphoma undergoing chemotherapy who were admitted to Department of Oncology in Xinxiang Central Hospital from September 2019 to September 2020 were selected as the research objects.According to the occurrence of PICC-related venous thrombosis,they were divided into the thrombosis group(n=23)and the non-thrombotic group(n=112).The general data,PICC catheter vein,catheter tip position,PICC catheter limb and other data were collected.Binomial Logistic regression analysis was used to analyze the risk factors of PICC-related venous thrombosis.Results The incidence of PICC-related venous thrombosis in lymphoma patients undergoing chemotherapy was 17.04%(23/135).Binomial logistic regression analysis showed that the catheterized vein was the cephalic vein,the catheter tip was located within the upper 2/3 of the superior vena cava,and the ratio of catheter diameter divided by vein diameter greater than or equal to 67%were independent risk factors of PICC-related venous thrombosis in lymphoma chemotherapy patients(P<0.01).Conclusions The risk factors of PICC-related venous thrombosis in lymphoma chemotherapy patients mainly include the cephalic vein,the catheter tip within the upper 2/3 of the superior vena cava and the ratio of catheter diameter to vein diameter greater than or equal to 67%.Nursing staff should focus on high-risk population and actively take interventions to reduce the incidence of PICC-related venous thrombosis.