Pan Longfang, Zhao Qianru, Yang Xiangmei
Department of Respiration, First Affiliated Hospital of Chongqing Medical University Chongqing 400016, China.
Int J Clin Exp Med. 2014 Dec 15;7(12):5814-9. eCollection 2014.
To evaluate the risk factors associated with an increased risk of symptomatic peripherally inserted central venous catheter (PICC)-related venous thrombosis. Retrospective analyses identified 2313 patients who received PICCs from 1 January 2012 to 31 December 2013. All 11 patients with symptomatic PICC-related venous thrombosis (thrombosis group) and 148 who did not have thromboses (non-thrombosis group) were selected randomly. The medical information of 159 patients (age, body mass index (BMI), diagnosis, smoking history, nutritional risk score, platelet count, leucocyte count as well as levels of D-dimer, fibrinogen, and degradation products of fibrin) were collected. Logistic regression analysis was undertaken to determine the risk factors for thrombosis. Of 2313 patients, 11 (0.47%) were found to have symptomatic PICC-related venous thrombosis by color Doppler ultrasound. Being bedridden for a long time (odds ratio [(OR]), 17.774; P=0.0017), D-dimer >5 mg/L (36.651; 0.0025) and suffering from one comorbidity (8.39; 0.0265) or more comorbidities (13.705; 0.0083) were the major risk factors for PICC-catheter related venous thrombosis by stepwise logistic regression analysis. Among 159 patients, the prevalence of PICC-associated venous thrombosis in those with ≥1 risk factor was 10.34% (12/116), in those with ≥2 risk factors was 20.41% (10/49), and in those with >3 risk factors was 26.67% (4/15). Being bedridden >72 h, having increased levels of D-dimer (>5 mg/L) and suffering from comorbidities were independent risk factors of PICC-related venous thrombosis.
评估与有症状的经外周静脉穿刺中心静脉置管(PICC)相关静脉血栓形成风险增加相关的危险因素。回顾性分析确定了2012年1月1日至2013年12月31日期间接受PICC置管的2313例患者。随机选取了所有11例有症状的PICC相关静脉血栓形成患者(血栓形成组)和148例无血栓形成患者(非血栓形成组)。收集了159例患者的医学信息(年龄、体重指数(BMI)、诊断、吸烟史、营养风险评分、血小板计数、白细胞计数以及D-二聚体、纤维蛋白原和纤维蛋白降解产物水平)。进行逻辑回归分析以确定血栓形成的危险因素。在2313例患者中,经彩色多普勒超声检查发现11例(0.47%)有症状的PICC相关静脉血栓形成。长期卧床(比值比[OR],17.774;P=0.0017)、D-二聚体>5mg/L(36.651;0.0025)以及患有一种合并症(8.39;0.0265)或更多合并症(13.705;0.0083)是经逐步逻辑回归分析得出的PICC导管相关静脉血栓形成的主要危险因素。在159例患者中,具有≥1个危险因素的患者中PICC相关静脉血栓形成的患病率为10.34%(12/116),具有≥2个危险因素的患者中为20.41%(10/49),具有>3个危险因素的患者中为26.67%(4/15)。卧床>72小时、D-二聚体水平升高(>5mg/L)以及患有合并症是PICC相关静脉血栓形成的独立危险因素。