老年患者中心静脉导管相关性血栓发生情况调查  

Central venous catheter-related thrombosis in elderly patients

作　　者：柳高[1] 付治卿[1] 李世军[1] 

机构地区：[1]解放军总医院南楼心血管内科,北京100853

出　　处：《中华老年心脑血管病杂志》2015年第11期1163-1166,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的调查老年患者中心静脉导管相关性血栓的发生情况,比较不同置管部位下,导管相关性血栓的发生率,将与血栓发生相关联的各种危险因素进行对比分析。方法选取接受中心静脉置管操作的老年患者405例,根据置管部位不同分为股静脉组46例,颈内静脉组40例,锁骨下静脉组319例。又根据导管相关性血栓的发生情况分为血栓组31例,非血栓组374例。对入选患者的性别、年龄、基础疾病、置管部位、导管留置时间、导管相关性血栓的发生情况等进行回顾性调查分析。结果锁骨下静脉组血栓发生率明显低于颈内静脉组和股静脉组(5.0%vs 15.0%,19.6%,P<0.05,P<0.01)。血栓组既往静脉血栓病史明显高于非血栓组(19.4%vs 6.4%,P<0.05)。结论老年患者通过锁骨下静脉途径进行置管,导管相关性血栓的发生率最低;静脉血栓史对老年患者中心静脉导管相关性血栓的发生同样具有预测作用。Objective To analyze the risk factors for thrombosis by investigating the incidence of central venous catheter-related thrombosis in elderly patients.Methods Four hundred and five elderly patients who underwent central venous catheterization were divided into femoral vein group（n=46）,internal jugular vein group（n=40）and subclavian vein group（n=319）according to their catheter position,or into thrombosis group（n=31）and non-thrombosis group（n=374）according to the incidence of central venous catheter-related thrombosis.Their gender,age,basic diseases,catheter position,retention time of catheter,and complications of central venous catheterrelated thrombosis were retrospectively analyzed.Results The incidence of central venous catheter-related thrombosis was significantly lower in subclavian vein group than in internal jugular vein group and femoral vein group（5.0%vs 15.0%,5.0% vs 19.6%,P〈0.05,P〈0.01）.The percentage of past venous thrombosis history was significantly higher in thrombosis group than in non-thrombosis group（19.4%vs 6.4%,P〈0.05）.Conclusions Subclavian vein catheterization can significantly reduce the incidence of central venous catheter-related thrombosis and past venous thrombosis history can predict the incidence of central venous catheter-related thrombosis in elderly patients.

关 键 词：导管插入术 中心静脉 血栓形成 导管 留置 锁骨下静脉 危险因素 

分 类 号：R54[医药卫生—心血管疾病]