| 食管癌化疗患者置入中心静脉导管相关性血栓的危险因素分析 |
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| 引用本文： | 裘成莉,潘巧玲,徐国栋,王雁飞,沈丽月,柳春娜.食管癌化疗患者置入中心静脉导管相关性血栓的危险因素分析[J].中华全科医学,2018,16(9):1566-1569. |
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| 作者姓名： | 裘成莉 潘巧玲 徐国栋 王雁飞 沈丽月 柳春娜 |
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| 作者单位： | 1. 宁波市医疗中心李惠利医院护理部, 浙江 宁波, 315040; |
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| 基金项目： | 浙江省自然科学基金(LQ16H160002) |
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| 摘 要： | 目的 外周静脉置入中心静脉导管(PICC)是恶性肿瘤患者静脉给药的常用途径,本文拟探讨食管癌化疗患者PICC相关性血栓形成的危险因素。 方法 选取2012年1月-2016年12月宁波市医疗中心李惠利医院收住的306例PICC置管的食管癌化疗患者,记录患者的一般资料(包括性别、年龄、食管癌手术史、病理类型、食管癌TNM分期、放疗史、静脉血栓史和糖尿病病史)和置管资料(包括穿刺肢体、PICC导管类型)后进行单因素分析(计量资料采用t检验,计数资料采用χ2检验),将有统计学意义的因素赋值并纳入多因素Logistic回归模型进行分析。 结果 PICC相关性血栓共发生25例,发生率为8.2%;单因素分析结果显示,食管癌TNM分期、静脉血栓史、放疗史、PICC导管类型与PICC相关性血栓的发生相关,差异有统计学意义(均P<0.05)。进一步通过多因素Logistic回归分析发现食管癌TNM分期(OR=2.879,95% CI:1.135~3.486)、静脉血栓史(OR=5.048,95% CI:1.712~14.835)和PICC导管类型(OR=3.764,95% CI:1.239~11.985)是PICC相关性血栓形成的独立危险因素(P<0.05)。 结论 食管癌TNM分期、静脉血栓史、PICC导管类型是食管癌化疗患者PICC相关性血栓形成的独立危险因素,对于该类患者,及时采取行之有效的预防措施,有望减少PICC相关性血栓的形成。
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| 关 键 词： | 食管癌 化疗 经外周静脉置入中心静脉导管 导管相关性血栓 危险因素分析 |
| 收稿时间： | 2017-10-26 |
Analysis of risk factors for PICC related thrombosis in esophageal cancer patients with chemotherapy |
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| Affiliation: | Nursing Department, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang 315041, China |
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| Abstract: | Objective Peripherally inserted central catheter (PICC) is a common way of intravenous administration in patients with malignant tumors. This study was designed to investigate the risk factors of PICC related thrombosis in esophageal cancer patients with chemotherapy. Methods From January 1, 2012 to December 31, 2016, a retrospective study was conducted on 306 cases of esophageal cancer patients with chemotherapy after PICC placement. The general data (including gender, age, surgery history of esophageal cancer, pathological type, TNM staging of esophageal cancer, radiotherapy history, history of venous thrombosis and history of diabetes) and catheterization data (including the puncture limb and the types of PICC catheter) were recorded and analyzed by single factor analysis, and the measurement data and numeration data were statistically analyzed with t test and χ2 test respectively. The factors that had statistical differences were assigned and enrolled in the multiple factor logistic regression analysis. Results A total of 25 patients developed PICC related thrombosis in 306 cases, and the incidence was 8.2%. The single factor analysis showed that TNM staging of esophageal cancer, history of radiotherapy,history of venous thrombosis and types of PICC catheter were related with the occurrence of PICC related thrombosis. Multiple factor logistic regression analysis showed that venous thrombosis (OR=5.048, 95% CI:1.712-14.835), type of the catheter (OR=3.764,95% CI:1.239-11.985) and TNM staging (OR=2.879,95% CI:1.135-3.486) were risk factors of catheter related thrombosis in esophageal cancer patients. Conclusion The TNM staging of esophageal cancer, history of venous thrombosis and types of PICC catheter were independent risk factors with PICC related thrombosis. For these patients,taking effective preventive measures can reduce the occurrence of PICC catheter related thrombosis. |
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