肝移植患者外周中心静脉置管术后发生静脉炎的相关因素分析

目的探讨肝移植患者外周中心静脉置管术(PICC)后发生静脉炎的危险因素。方法追踪180例肝移植患者置管时的穿刺记录、凝血功能指标、免疫功能指标、营养状况指标、血糖水平,分析其与PICC后产生静脉炎的相关性。结果 180例患者中静脉炎的发生率是15.6%(28/180)。将静脉炎组与无静脉炎的对照组患者上述观察项目进行比较,将组间差异有统计学意义的因素作为自变量,将是否出现静脉炎作为因变量进行Logistic多元回归分析。结果显示,年龄、性别、原发疾病、置管静脉、穿刺部位、尝试置管次数是肝移植患者PICC后发生静脉炎的危险因素。结论肝移植患者进行PICC时,医护人员应特别关注女性老年肝癌患者,尽量选择贵要静脉,肘上穿刺,保证一次性置管,以降低患者置管后静脉炎的发生率,保证PICC在肝移植患者中的正常使用。

Research on Related Factors of Phlebitis after PICC Placement in Liver Transplantation

Objective To explore the risk factors of phlebitis after peripherally inserted central catheter(PICC) placement in patients with liver transplantation.Methods Puncture record,blood clotting index,immune function index,nutrition status indicators and blood sugar level were collected in 180 patients with liver transplantation to analyze the relationship between the indicators and the occurrence of phlebitis after PICC.Results The incidence of phlebitis was 15.6%(28/180)in 180 cases.The above-mentioned indicators were compared between phlebitis group and no phlebitis control group.Indicators with statistically significant differences between the two groups were taken as independent variables,while the occurrence of phlebitis was taken as dependent variable for multiple Logistic regression analysis.The analysis showed that age,sex,primary disease,catheter vein,puncture,numbers of trying to place the tube were the risk factors of PICC phlebitis in patients with liver transplantation.Conclusion Medical personnel should pay special attention to aged women patients with liver cancer,and choose basilica vein by puncturing in the elbow to ensure one time catheter placement,which can reduce the incidence of phlebitis after catheter placement and guarantee the normal use of PICC in liver transplantation patients.