肺癌化疗病人输液港相关血栓形成的影响因素分析及护理对策

Analysis of influencing factors and nursing strategies of infusion port-related thrombosis in chemotherapy patients with lung cancer

目的:对肺癌化疗病人输液港相关血栓形成的影响因素进行分析,并提出护理对策。方法:选择2016年7月至2019年3月收治的158例肺癌使用输液港病人为研究对象,回顾其临床资料,对输液港相关血栓形成的影响因素进行单因素和非条件多因素logistic回归分析,探讨输液港相关血栓形成的风险因素,并应用ROC曲线验证logistic回归的预测效果。结果:肺癌化疗病人输液港相关血栓发生31例(19.6%),单因素和多因素logistic回归分析显示,留置时间、血液高凝状态、肿瘤分类、化疗方案是输液港相关血栓形成的主要影响因素(P<0.05~P<0.01)。多因素logistic回归模型预测概率P进行ROC曲线验证,可得AUC为0.905(95%CI为0.884~0.927),敏感度为0.861,特异性为0.793,约登指数为0.654。结论:肺癌化疗病人输液港相关血栓与导管留置时间、血液高凝状态、肿瘤分类、化疗方案有关,护士应做好静脉血栓栓塞症高危人群的筛查和宣教,建立输液港出院随访登记制度,加强基层医院及社区护理人员的标准化培训,以降低输液港血栓发生率。

Objective:To analyze the influencing factors of infusion port-related thrombosis in chemotherapy patients with lung cancer,and to propose nursing strategies.Methods:A total of 158 patients with lung cancer from July 2016 to March 2019 were taken as the research objects.The influencing factors of the infusion port-related thrombosis were analyzed by univariate and unconditional multivariate logistic regression analysis.The risk factors of thrombosis related to infusion port were explored,and the predictive effect of logistic regression was verified using ROC curve.Results:Thirty-one cases(19.6%)of infusion port-related thrombosis occurred in lung cancer chemotherapy patients.Univariate and multivariate logistic regression analysis showed that indwelling time,blood hypercoagulability status,tumor classification,and chemotherapy regimens were the main factors of infusion port-related thrombosis(P<0.05 to P<0.01).The multivariate logistic regression model predicted the probability P for ROC curve verification,and the AUC was 0.905(95%CI:0.884-0.927),the sensitivity was 0.861,the specificity was 0.793,and the Youden index was 0.654.Conclusions:Infusion port-related thrombosis in lung cancer chemotherapy patients is related to catheter indwelling time,blood hypercoagulability status,tumor classification,and chemotherapy regimens.Nurses should do a good job in screening and education of venous thromboembolism high-risk groups,establish a follow-up registration system at the infusion port,and strengthen the standardized training of nursing staff in primary hospitals and communities,so as to reduce the incidence of thrombosis in the infusion port.