Yi Xiao-lei, Chen Jie, Li Jia, Feng Liang, Wang Yan, Zhu Jia-An, Shen E, Hu Bing
Department of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
J Clin Nurs. 2014 Mar;23(5-6):837-43. doi: 10.1111/jocn.12227. Epub 2013 May 28.
To investigate the incidence and risk factors for peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer.
With the widespread use of peripherally inserted central venous catheters, peripherally inserted central venous catheters-related upper extremity venous thrombosis in patients with cancer leads to increasing morbidity and mortality. It is very important to further explore the incidence and risk factors for peripherally inserted central venous catheters-related venous thrombosis.
Consecutive patients with cancer who were scheduled to receive peripherally inserted central venous catheters, between September 2009 and May 2012, were prospectively studied in our centre. They were investigated for venous thrombosis by Doppler sonography three times a day within 30 days after catheter insertion. Univariable and multivariable logistic regressions' analyses were performed to identify the risk factors for peripherally inserted central venous catheters-related thrombosis.
A total of 89 patients with cancer were studied in our research. Of these, 81 patients were followed up within one month. The mean interval between catheter insertion and the onset of thrombosis was 12.45 ± 6.17 days. The multivariable analyses showed that chemotherapy history, less activities and diabetes were the key risk factors for thrombosis.
Peripherally inserted central venous catheters-related upper extremity venous thrombosis had high incidence rate, and most cases had no significant symptoms. The history of chemotherapy, less activities and diabetes were found to be the key risk factors. It should be routinely scanned in high-risk patients every 3-5 days after catheter insertion, which would then find blood clots in time and reduce the incidence of pulmonary embolism.
Risk factors associated with peripherally inserted central venous catheters-related upper extremity venous thrombosis are of critical importance in improving the quality of patients' life. It is very important to grasp the indications to reduce the incidence rate of peripherally inserted central venous catheters-related upper extremity venous thrombosis.
探讨癌症患者外周静脉穿刺中心静脉置管相关上肢静脉血栓形成的发生率及危险因素。
随着外周静脉穿刺中心静脉置管的广泛应用，癌症患者外周静脉穿刺中心静脉置管相关上肢静脉血栓形成导致发病率和死亡率不断上升。进一步探究外周静脉穿刺中心静脉置管相关静脉血栓形成的发生率及危险因素非常重要。
2009年9月至2012年5月期间，本中心对计划接受外周静脉穿刺中心静脉置管的连续癌症患者进行前瞻性研究。在置管后30天内，每天用多普勒超声对他们进行3次静脉血栓检查。采用单因素和多因素逻辑回归分析来确定外周静脉穿刺中心静脉置管相关血栓形成的危险因素。
本研究共纳入89例癌症患者。其中，81例患者接受了为期1个月的随访。置管至血栓形成的平均间隔时间为12.45±6.17天。多因素分析显示，化疗史、活动较少和糖尿病是血栓形成的关键危险因素。
外周静脉穿刺中心静脉置管相关上肢静脉血栓形成发生率较高，且多数病例无明显症状。化疗史、活动较少和糖尿病是关键危险因素。置管后应每3 - 5天对高危患者进行常规扫描，以便及时发现血凝块并降低肺栓塞的发生率。
外周静脉穿刺中心静脉置管相关上肢静脉血栓形成的危险因素对于提高患者生活质量至关重要。掌握适应证对于降低外周静脉穿刺中心静脉置管相关上肢静脉血栓形成的发生率非常重要。
