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肢体缺血预处理对经外周静脉置入中心静脉导管患者静脉血栓发生率的影响。

Impact of limb ischemic preconditioning on the incidence of vein thrombosis in patients with peripherally inserted central catheter.

机构信息

Clinic for Kidney and Hypertensive Diseases, Hanover Medical School, Hanover, Germany.

Department of Hepatobiliary Pancreatic Center, Xuzhou City Central Hospital, The Xuzhou School of Clinical Medicine of Nanjing Medical University, The Affiliated Hospital of the Southeast University Medical School, Xuzhou, Jiangsu, China.

出版信息

Pathol Oncol Res. 2024 Nov 14;30:1611596. doi: 10.3389/pore.2024.1611596. eCollection 2024.

Abstract

BACKGROUND

Peripherally inserted central catheters (PICC) are increasingly used in clinical practice, which also leads to an increased incidence of PICC-related thrombosis. Local thrombus formation could be prevented by limb ischemic preconditioning (IPC). This study aimed to determine whether IPC can prevent deep vein thrombosis in patients with PICC.

METHODS

A total of 600 breast cancer patients receiving PICC were randomized into two groups between July 2016 and July 2018 at the Department of Radiation Oncology. In the preconditioning group, 5 min of ischemic preconditioning was performed three times before PICC, whereas no preconditioning was performed in the sham group. The coagulation function levels, the PICC-related complications, the length of hospital stay, the cost of hospitalization, and the satisfaction of patients were compared.

RESULTS

The coagulation function levels of patients in the preconditioning group were more normal than in patients from the sham group. In total, 56/300 patients in the sham group had presence of PICC-related thrombosis, with only 23/300 in the IPC group, with no significant difference in other complications between the two groups. However, a longer hospital stay was observed in the sham group compared to the IPC group. Moreover, the cost of hospitalization was also reduced in the IPC group, which also improved the satisfaction of patients.

CONCLUSION

Limb ischemic preconditioning may attenuate the severity of vein thrombosis in patients with PICC, which contributes to reducing the incidence of PICC-related thrombosis in clinical practice.

摘要

背景

外周静脉置入中心静脉导管(PICC)在临床实践中的应用越来越广泛,这也导致 PICC 相关血栓形成的发生率增加。肢体缺血预处理(IPC)可预防局部血栓形成。本研究旨在确定 IPC 是否可以预防 PICC 患者的深静脉血栓形成。

方法

2016 年 7 月至 2018 年 7 月,在放射肿瘤科,将 600 例接受 PICC 的乳腺癌患者随机分为两组。在预处理组中,在 PICC 前进行 3 次 5 分钟的缺血预处理,而假处理组则不进行预处理。比较两组凝血功能水平、PICC 相关并发症、住院时间、住院费用和患者满意度。

结果

预处理组患者的凝血功能水平较假处理组更为正常。假处理组 300 例患者中有 56 例发生 PICC 相关血栓形成,IPC 组仅 23 例,两组其他并发症无显著差异。然而,假处理组的住院时间长于 IPC 组。此外,IPC 组的住院费用也降低了,这也提高了患者的满意度。

结论

肢体缺血预处理可减轻 PICC 患者静脉血栓形成的严重程度,有助于降低临床实践中 PICC 相关血栓形成的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22bb/11602314/6ea5a5c105be/pore-30-1611596-g001.jpg

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