中心静脉导管相关性深静脉血栓形成及其药物预防的探讨

目的观察中心静脉导管相关性深静脉血栓形成(central venous catheter-related deep venous thrombosis,CVC-relatedDVT)的发生率;探讨预防性抗凝治疗对预防CVC-related DVT的有效性及安全性。方法112例因治疗需要置入中心静脉导管的患者,分为低分子肝素皮下注射治疗组(0.6 mL/d)及对照组各56例,中心静脉导管置入后1周、2周、4周、6周先后4次对入组患者导管所在深静脉及其临近深静脉进行血管彩色多普勒超声检查,观察是否有CVC-related DVT,同时观察出血不良反应。结果导管置入6周后,对照组及治疗组CVC-related DVT发生率分别为12.5%和1.8%,差异有统计学意义(P<0.05);治疗组中没有大出血发生。结论本研究结果显示中心静脉导管相关性深静脉血栓形成的发生率为12.5%(7/56),低分子肝素(0.6mL/d)皮下注射预防性抗凝治疗能显著降低其发生率。

Deep Venous Thrombosis Related with Central Venous Catheter and Its Medical Prevention

Objective To observe the probability of deep venous thrombosis related with central venous catheter(CVC-related DVT), to explore the efficacy and safety of prophylactic anticoagulant therapy for the prevention of CVC-related DVT. Methods Totally 112 patients who had received CVC insertion were randomly assigned into two groups, the patients in the therapy group were given subcutaneous low-molecular-weight-heparin 0.6 mL once a day and those in the control group were not given any anticoagulant. Color Doppler ultrasound examination was performed for each patient at the end of the first, the second, the forth and the sixth week respectively after CVC insertion to confirm the development of CVC-related DVT. Meanwhile, bleeding complications were observed. Results The probability of CVC-related DVT in the control group and the therapy group were 12.5%(7/56) and 1.8%(1/56) separately, the difference was statistically significant. No major bleeding complication occurred in therapy group. Conclusion The probability of CVC-related DVT was significantly higher than that of the control group, the incidence can be reduced by prophylactic anticoagulant therapy with subcutaneous low-molecular-weight-heparin.