经外周中心静脉置管化疗后置管侧上肢静脉血栓形成分析及对策  

Analysis of venous thrombosis occurrence on upper limb with catheter after chemotherapy by peripherally inserted central catheter and its countermeasures

作　　者：张玲芳[1] 陶志芳[1] 凡国华[1] 陆婷[1] 

机构地区：[1]江苏省苏北人民医院肿瘤科,江苏扬州225001

出　　处：《实用临床医药杂志》2016年第22期44-46,50,共4页Journal of Clinical Medicine in Practice

摘　　要：目的分析恶性肿瘤患者经外周中心静脉置管（PICC）化学治疗后置管侧上肢静脉血栓发生原因并提出防治对策。方法观察160例经PICC化疗的不同恶性肿瘤患者置管侧上肢静脉血栓发生数及发生时间,分析血栓形成的可能原因并提出防治对策。结果本组共发生置管侧上肢静脉血栓4例,其中肺肿瘤患者2例,胃肠道肿瘤患者2例。PICC上肢静脉血栓发生率2.5%。血栓发生时间多数在化疗后7-14 d。结论 PICC化疗后,7-14 d是置管侧上肢静脉血栓发生的高危期。肿瘤及化疗药物、穿刺血管损伤、导管头端异位、上肢活动是血栓形成的主要原因。因此,合理地选择穿刺血管、准确定位,肿瘤患者治疗全过程的严密观察和化疗后凝血指标的监控,以及出院后的随访,能够有效预防置管侧上肢静脉血栓的发生。Objective To analyze the causes and to propose countermeasures of the venous thrombosis on upper limb with catheter after chemotherapy by peripherally inserted central catheter（ PICC） in patients with malignant tumor. Methods The number and time of venous thrombosis on upper limb with catheter after chemotherapy by PICC were observed in 160 malignant tumor patients.The causes of the venous thrombosis occurrence were analyzed and countermeasures were put forward.Results There were 4 cases with the venous thrombosis,including 2 cases with lung cancer,and 2cases with gastrointestinal tumor. The incidence rate of the venous thrombosis was 2. 5%. The time of thrombosis occurrence after chemotherapy was 7 - 14 days. Conclusion The high risk period of the upper limb vein thrombosis is 7 - 14 days after chemotherapy. Tumor and chemotherapy drugs,vascular puncture injury,catheter ectopic,upper limb activities are the main reasons of thrombosis. To prevent effectively the occurrence of venous thrombosis on upper limb,reasonably selection of vascular puncture,accurately locatation,closely observation and monitoring of blood coagulation and the follow-up after discharge should be done during the whole course of treatment.

关 键 词：PICC 化学治疗 上肢静脉血栓 对策 

分 类 号：R473.73[医药卫生—护理学]