PICC置管后血栓形成的危险因素和护理体会

目的探讨经外周静脉穿刺中心静脉置管(PICC置管)后血栓形成的危险因素及相关护理体会。方法回顾性分析2013年9月至2014年3月于我院行PICC置管干预的288例住院患者临床资料。根据其置管后血栓形成情况分成血栓组(n=86)和正常对照组(n=202)。对两组年龄、性别、肥胖情况、基础疾病(糖尿病、高血脂症、高血压)、吸烟史、抗凝剂使用情况、既往血栓史或栓塞史、活动量、导管置入时穿刺次数、PICC专业护理人员干预情况、导管管径等行单因素及多因素Logistic回归分析。结果血栓组和正常对照组患者年龄、性别、肥胖情况、吸烟史等一般资料比较无统计学意义(P0.05);多因素Logistic回归分析结果显示,糖尿病、每日活动量偏少(每日活动时间1 h)、导管管径大(≥5 F)、未接受PICC专业护理人员干预等是PICC置管后血栓形成的独立危险因素(P0.05)。结论PICC置管后血栓的形成同活动量、导管管径、合并糖尿病及专业护理关系密切,需引起重视。

Risk Factors and Nursing Experience of Thrombosis After PICC

Objective To explore the risk factors and nursing experience of thrombosis after peripherally inserted central catheter (PICC).Methods The clinical data of 288 hospitalized patients who underwent PICC in our hospital between September 2013 and March 2014 were retrospectively analyzed.According to the status of thrombosis,they were divided into thrombosis group(n =86)and the control group(rn =202).Age,gender,obesity,underlying diseases (diabetes,hyperlipidemia,hypertension),smoking history,use of anticoagulants,previous history of thrombosis or embolism history,activity,the times of puncture,intervention given by professional nursing staff of PICC and diameter of catheter were analyzed by univariate and multivariate Logistic regression analysis.Results There were no significant differences in age,gender,obesity and smoking history between the two groups (P ＞ 0.05).Multivariate Logistic regression analysis showed that diabetes,few daily activities less(time of daily activities ＜ 1 h),large diameter of catheter(≥ 5F),without intervention given by professional nursing staff of PICC were the independent risk factors of thrombosis after PICC(P ＜ 0.05).Conclusion Thrombosis after PICC is closely related to activity,diameter of catheter,diabetes mellitus and professional nursing,which needs to be paid attention to.