肿瘤患者PICC相关上肢无症状静脉血栓的临床调查研究

目的:分析肿瘤患者PICC相关上肢无症状静脉血栓形成的临床特点,为血栓早期预防提供理论依据.方法:选取2017年4月至2018年10月PICC置管的肿瘤患者127例,在置管前和置管后第2、7、14、21、28、35、42天应用彩色多普勒超声对置管侧上肢静脉的穿刺点、穿刺点上方2 cm处、肘窝上方10 cm处和腋窝4个部...

A clinical investigation of PICC-related upper extremity asymptomatic venous thrombosis in cancer patients

Objective: To investigate the clinical characteristics of PICC-related upper extremity asymptomatic venous thrombosis in cancer patients, and to provide theoretical basis for the early prevention of venous thrombosis. Methods: A total of 127 cancer patients with PICC catheterization from April 2017 to October 2018 were selected. Doppler ultrasound was used to examine the puncture point, 2 cm above the puncture point, 10 cm above the elbow fossa and armpit of the upper extremity on the side of the catheter. The examinations were before catheterization and on days 2 nd, 7 th, 14 th, 21 st, 28 th, 35 th, and 42 nd after catheterization. Results: The incidence of asymptomatic venous thrombosis was 48.82% and the median time of thrombosis was 3 day. A total of 81 thrombosis were detected in 62 patients, of which deep vein thrombosis accounted for 23.46% and superficial vein thrombosis accounted for 76.54%. The rates of thrombus classification(I, II, III) were 51.85%, 37.04%, 11.11% respectively. Logistic regression analysis showed that ECOG(OR=9.185, 95%CI 4.770-28.262, P<0.001), venous flow velocity(OR=0.577, 95%CI 0.506-0.858, P=0.002) were associated with the development of asymptomatic thrombosis. ROC curve analysis of the risk value of venous flow velocity was 4.78 cm/s(AUC is 0.739, 95%CI 0.649-0.830). Conclusion: The incidence of PICC-related asymptomatic thrombosis in cancer patients is high. It mostly occurs 2-10 cm above the puncture site. It is suggested that pre-catheterization screening and intervention measures should be conducted in high-risk population with low activity and venous flow rate ≤ 4.78 cm/s to prevent the occurrence of asymptomatic venous thrombosis.