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凝血指标变化在肿瘤患者PICC相关静脉血栓形成早期诊断及护理干预中的临床价值

Clinical Value of Coagulation Index Changes in Early Diagnosis and Nursing Intervention for PICC-Related Venous Thrombosis in Tumor Patients.

作者信息

Gai Meihua, He Wenjuan

机构信息

Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Nursing Department, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital Hangzhou Medical College), Hangzhou, Zhejiang, China.

Emergency and Critical Care Center, Nursing Department, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital Hangzhou Medical College), Hangzhou, Zhejiang, China.

出版信息

Contrast Media Mol Imaging. 2022 Aug 13;2022:7579225. doi: 10.1155/2022/7579225. eCollection 2022.

Abstract

PURPOSE

To explore the clinical value of coagulation index changes in early diagnosis and nursing intervention for PICC-related venous thrombosis in tumor patients. . A total of 170 tumor patients hospitalized for the first time with catheterization were enrolled from February 2018 to June 2022. According to the diagnostic criteria of venous thromboembolism, high-risk patients with venous thrombosis within 13 days after catheterization were enrolled in the observation group, and those without thromboembolism were enrolled in the control group. Venous blood was taken from all patients on days 1, 5, 9, and 13 after catheterization to measure the change trend of coagulation indexes of patients and to compare the difference of coagulation indexes between the observation group and the control group.

RESULTS

PT values of all patients were within the normal reference range at days 1, 5, 9, and 13 after catheterization. Compared with the control group, the observation group was significantly reduced on days 5, 9, and 13 after catheterization ( < 0.05), and continued to decrease with the prolonging of time( < 0.05). After catheterization, the values of all patients at each time point were lower than the normal reference range. Compared with the control group, the values of tumor patients in the observation group were significantly decreased on days 5, 9, and 13 ( < 0.05) and continued to decrease at each time point ( < 0.05). DD values in the observation group were all higher than the normal reference range on days 1, 5, 9, and 13 after catheterization. Compared with the control group, DD values in the observation group were significantly higher on days 1, 5, 9, and 13 after catheterization ( < 0.05).

CONCLUSION

PT and APTT continued to decrease after catheterization, and DD kept fluctuating at a high level, highly suggesting the possibility of venous thrombosis. The nursing staff should keep high vigilance and give appropriate nursing intervention.

摘要

目的

探讨凝血指标变化在肿瘤患者经外周静脉穿刺中心静脉置管(PICC)相关静脉血栓形成早期诊断及护理干预中的临床价值。2018年2月至2022年6月,共纳入170例首次住院行导管置入的肿瘤患者。根据静脉血栓栓塞症的诊断标准,将置管后13天内发生静脉血栓的高危患者纳入观察组,未发生血栓栓塞的患者纳入对照组。于置管后第1、5、9和13天采集所有患者的静脉血,检测患者凝血指标的变化趋势,并比较观察组与对照组凝血指标的差异。

结果

置管后第1、5、9和13天,所有患者的凝血酶原时间(PT)值均在正常参考范围内。与对照组相比,观察组在置管后第5、9和13天显著降低(P<0.05),且随时间延长持续下降(P<0.05)。置管后各时间点所有患者的PT值均低于正常参考范围。与对照组相比,观察组肿瘤患者在第5、9和13天的PT值显著降低(P<0.05),且各时间点均持续下降(P<0.05)。观察组在置管后第1、5、9和13天的D-二聚体(DD)值均高于正常参考范围。与对照组相比,观察组在置管后第1、5、9和13天的DD值显著升高(P<0.05)。

结论

置管后PT和活化部分凝血活酶时间(APTT)持续下降,DD持续在高水平波动,高度提示静脉血栓形成的可能性。护理人员应保持高度警惕并给予适当的护理干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c62/9392612/f96cb90c23cc/CMMI2022-7579225.001.jpg

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