Venous Catheterization Nursing Clinic, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital, Shenzhen, Guangdong Province, China 518100.
Nursing Department, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital, Shenzhen, Guangdong Province, China 518100.
Comput Math Methods Med. 2022 Oct 17;2022:1239058. doi: 10.1155/2022/1239058. eCollection 2022.
This study intended to analyze hazardous factors of venous thrombosis by comparing the effect of different doses of heparin sodium injection on the incidence rate of peripherally inserted central catheter (PICC)-related venous thrombosis in non-small cell lung carcinoma (NSCLC) patients during postoperative chemotherapy.
425 NSCLC patients who received PICC catheterization in Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital from July 2019 to July 2021 were collected. Based on their different pathological types, patients were given two different chemotherapy regimens: pemetrexed+cisplatin or paclitaxel+cisplatin. Patients were grouped according to the different doses of heparin sodium injection adopted. Control group ( = 140). Catheters were sealed with 10 mL saline only. Group I ( = 142). In addition to routine maintenance with normal saline, 2 mL of 10 IU/mL heparin sodium injection was sealed in the catheters under positive pressure every time after catheterization. Group II ( = 143). In addition to routine maintenance with normal saline, 5 mL of 10 IU/mL heparin sodium injection was sealed in the same manner as Group I. The baseline characteristics of the three groups of patients were compared by statistical means. Doppler ultrasonography was applied to check the venous thrombosis. The hazardous factors of venous thrombosis were analyzed through correlation analysis and binary logistic regression method.
The incidence rates of thrombosis in the control group, Group I, and Group II were 20.00%, 7.04%, and 2.09%, respectively, with statistically significant differences ( < 0.01). Additionally, through the collinear correlation analysis of baseline characteristics, a significant correlation between the dosage of heparin sodium injection and the incidence of thrombosis was observed ( < 0.05), but there were no significant differences between other baseline data and the incidence of thrombosis ( > 0.05). Binary logistic regression analysis revealed that postoperative use of heparin sodium injection (Group I: OR = 0.312; = 0.003; Group II: OR = 0.082, < 0.001) was a protective factor for preventing thrombosis. In addition, the thromboprophylaxis effect of Group II was better than that of Group I. No serious adverse reactions were found in safety analysis.
Heparin sodium could significantly lower the incidence rate of PICC-related venous thrombosis in NSCLC patients during postoperative chemotherapy. Heparin sodium injection is safe enough to be promoted among PICC patients with a high risk of venous thrombosis.
通过比较不同剂量的肝素钠注射液对非小细胞肺癌（NSCLC）患者术后化疗期间外周置入中心静脉导管（PICC）相关静脉血栓形成发生率的影响，分析其危险因素。
收集 2019 年 7 月至 2021 年 7 月在中国医学科学院肿瘤医院深圳医院接受 PICC 置管的 425 例 NSCLC 患者。根据不同的病理类型，患者给予两种不同的化疗方案：培美曲塞+顺铂或紫杉醇+顺铂。根据肝素钠注射液的不同剂量分为三组：对照组（n=140），仅用 10 mL 生理盐水封管。组 I（n=142），置管后每次均用 2 mL 10 IU/mL 的肝素钠注射液正压封管，加用常规生理盐水维持。组 II（n=143），用与组 I 相同方式加用 5 mL 10 IU/mL 的肝素钠注射液，用常规生理盐水维持。采用统计学方法比较三组患者的基线特征。采用多普勒超声检查静脉血栓形成情况。采用相关性分析和二元逻辑回归方法分析静脉血栓形成的危险因素。
对照组、组 I 和组 II 的血栓形成发生率分别为 20.00%、7.04%和 2.09%，差异有统计学意义（<0.01）。此外，通过对基线特征的共线性相关性分析，发现肝素钠注射液的剂量与血栓形成的发生率呈显著相关性（<0.05），但其他基线数据与血栓形成的发生率无显著差异（>0.05）。二元逻辑回归分析显示，术后使用肝素钠注射液（组 I：OR=0.312，=0.003；组 II：OR=0.082，<0.001）是预防血栓形成的保护因素。此外，组 II 的血栓预防效果优于组 I。安全性分析未发现严重不良反应。
肝素钠可显著降低 NSCLC 患者术后化疗期间 PICC 相关静脉血栓形成的发生率。肝素钠注射液在有高静脉血栓形成风险的 PICC 患者中使用是安全的，可以推广。
