肿瘤化疗患者PICC相关性上肢静脉血栓形成时间及其影响因素分析

目的 比较肿瘤化疗患者经外周静脉穿刺的中心静脉导管(PICC)置管后不同阶段上肢静脉血栓的临床特征,并探讨不同阶段血栓形成的影响因素.方法 采用前瞻性观察对PICC置管化疗的3142例肿瘤患者进行跟踪调研、比较分析.置管后1～30 d出现PICC相关性上肢静脉血栓(PICC-related UEVT)的患者为近期血栓组...

Analysis of the time to and influencing factors for peripherallyinserted central catheter-related upper extremity venous thrombosisin patients with tumor undergoing chemotherapy*

Objective To compare the clinical characteristics of the upper extremity veinous thrombosis(UEVT) and to explore the influencing factors of thrombosis in different stages after peripherally inserted centralcatheter (PICC) placement in patients with tumor undergoing chemotherapy. Methods We prospectively followedup 3142 patients with tumor undergoing chemotherapy treated with PICC and analyzed relevant clinical data.Patients developing PICC-related UEVT 1 to 30 days or 31 to 210 days after PICC placement were included in shorttermthrombosis group (n = 86) or long-term thrombosis group (n = 68). Results The overall incidence of PICC-related UEVT was 4.90% with a total number of 154 patients. The incidence of asymptomatic thrombosis was higherin the short-term thrombosis group, while that of symptomatic thrombosis was higher in long-term thrombosis group(P < 0.05). The clinical symptoms and other complications associated with PICC were different between the twogroups (P < 0.05), but there was no difference in the vein with thrombosis, the degree of thrombosis, history ofPICC, site of puncture, the vein selected for puncture, catheter diameter to vein diameter ratio, length of catheter, thenumber of puncture, the number of catheter placement and the position of catheter tip between the two groups (P >0.05). The time to PICC-related UEVT from the last chemotherapy was short in short-term thrombosis group butlong in long-term thrombosis group. The history of surgery and platelet-stimulating agent use were different betweenthe two groups (P < 0.05), whereas the history of radiotherapy, total parenteral nutrition, blood transfusion,erythropoietin and chemotherapy drug use were not different between the two groups (P > 0.05). After anticoagulantand thrombolytic treatments, the venous thrombosis in short-term thrombosis group was milder than that in longtermthrombosis group (P < 0.05). Conclusions The incidence of PICC-related UEVT in patients with tumorundergoing chemotherapy shows a dynamic trend - being first high, then low and slowly on the rise - with the changeof catheter placement time. The characteristics and related factors of thrombosis in distinct stages after catheterplacement are different. Thus, corresponding intervention measures should be taken to reduce the incidence of PICCrelatedUEVT.