摘要
目的 探讨肺癌化疗经外周静脉穿刺置入中心静脉导管(PICC)患者发生深静脉血栓(DVT)的相关危险因素.方法 选择2021年1月至2023年5月在本院行PICC置管化疗患者96例为研究对象,经医院电子病历系统收集患者资料,调查肺癌化疗PICC置管患者发生DVT情况,并分析其发生的相关危险因素.结果 96例PICC置管化疗患者中发生DVT 27例(28.1％),未发生DVT 69例(71.9％);将27例发生DVT患者设为DVT组,其余69例患者设为非DVT组,单因素分析:吸烟史、穿刺次数、肿瘤分期、置管肢体活动、合并糖尿病、置管前D-D水平、病理类型、导管尖端位置、体重指数与肺癌化疗PICC置管患者发生DVT有关,差异有统计学意义(P＜0.05);性别、合并高血压、年龄、同步放疗、住院时间与肺癌化疗PICC置管患者发生DVT无关,差异无统计学意义(P＞0.05);多因素分析显示:有吸烟史[OR值(95％CI)=2.911(1.123,7.547)]、肿瘤分期Ⅲ～Ⅳ期[OR值(95％CI)=2.631(1.042,6.646)]、置管肢体活动过度或缺失[OR值(95％CI)=10.057(3.354,30.156)]、合并糖尿病[OR值(95％CI)=3.308(1.296,8.439)]、置管前 D-二聚体(D-D)水平＞0.5 mg/L[OR值(95％CI)=3.632(1.432,9.213)]、腺癌[OR值(95％CI)=5.720(1.940,16.867)]、导管尖端位于上腔静脉上 2/3[OR值(95％C/)=3.289(1.305,8.294)]、体质指数≥25 kg/m2[OR值(95％CI)=5.444,(1.947,15.221)]是肺癌化疗PICC置管患者发生DVT的高危因素(P＜0.05).结论 肺癌化疗PICC置管患者易发生DVT,其发生受多种因素共同影响,临床针对各危险因素制定预防措施干预,可能减少DVT发生.
Abstract
Objective To explore the relevant risk factors for deep vein thrombosis(DVT)in patients with peripherally inserted central catheters(PICC)for lung cancer chemotherapy.Methods Ninety-six patients who underwent PICC catheterization chemotherapy in our hospital from January 2021 to May 2023 were selected as the research subjects.Patient data were collected through the hospital's electronic medical record system to investigate the incidence of DVT in lung cancer patients undergoing PICC catheterization chemotherapy,and the relevant risk factors for its occurrence were analyzed.Results Among the 96 patients undergoing PICC catheterization chemotherapy,27 cases(28.1％)developed DVT,while 69 cases(71.9％)did not;27 patients with DVT were set as DVT group,and the other 69 patients were set as non DVT group.Univariate analysis:smoking history,punc-ture times,tumor stage,intubation limb activity,combined diabetes,pre intubation D-D level,pathological type,catheter tip position,body mass index were related to the occurrence of DVT in lung cancer chemotherapy PICC patients,and the difference was statistically significant(P＜0.05).Gender,concomitant hypertension,age,concur-rent radiation therapy,and length of hospital stay were not associated with the occurrence of DVT in lung cancer patients undergoing PICC catheterization during chemotherapy,and the difference was not statistically significant(P＞0.05).Multivariate analysis shows a history of smoking[OR(95％CI)=2.911(1.123,7.547)],tumor stage Ⅲ-Ⅳ[OR(95％CI)=2.631,(1.042,6.646)],excessive or absent limb activity during catheterization[OR(95％CI)=10.057(3.354,30.156)],combined with diabetes[OR(95％CI)=3.308(1.296,8.439],D-D level before catheterization＞0.5 mg/L[OR(95％CI)=3.632(1.432,9.213)],adenocarcinoma[OR(95％CI)=5.720(1.940,16.867)],catheter tip located on 2/3 of the superior vena cava[OR(95％CI)=3.289(1.305,8.294)]and body mass index ≥ 25 kg/m2[OR(95％CI)=5.444(1.947,15.221]are high-risk factors for DVT in lung cancer patients undergoing PICC catheterization during chemotherapy(P＜0.05).Conclusion Patients with PICC catheterization during chemotherapy for lung cancer are prone to DVT,which is influenced by multiple factors.Developing preventive measures for each risk factor in clinical practice may reduce the occurrence of DVT.
维普
万方数据