PICC相关性上肢静脉血栓风险评估模型的构建与评价  

Development and validation of a risk scoring model to predict peripherally inserted central catheter-related upper extremity venous thrombosis

作　　者：陈江琼 闫常帅 张杰[2] 康楠[2] 胡芳[3] Chen Jiangqiong;Yan Changshuai;Zhang Jie;Kang Nan;Hu Fang(Department of Endocrinology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院内分泌科,重庆400016 [2]天津医科大学总医院普通外科超声介入治疗室 [3]天津医科大学总医院护理部

出　　处：《护理学杂志》2018年第17期1-5,共5页Journal of Nursing Science

摘　　要：目的构建PICC相关性上肢静脉血栓风险评估模型并进行评价,为PICC相关性上肢静脉血栓的评估、预防及护理提供参考。方法采用便利抽样法收集375例PICC置管患者资料,于置管7、14、21、28d进行常规超声或超声造影检查,判断血栓发生状况;利用统计分析方法构建血栓风险评估模型,并进行验证和初步评价。结果 PICC相关性上肢静脉血栓发生率为19.2%;Logistic回归分析显示,肥胖、糖尿病、血栓史、化疗史、D-二聚体(≥0.5mg/L)为独立危险因素;根据各独立危险因素的优势比建立风险评估模型并进行危险度分级;评估模型的最佳截断值为4.5分,ROC曲线下面积为0.758。结论 PICC相关性上肢静脉血栓风险评估模型评估条目少,可操作性强,预测效能可接受,能用于临床快速筛查PICC置管上肢静脉血栓风险患者。Objective To develop and validate a risk scoring model to predict peripherally inserted central catheter（PICC）related upper extremity venous thrombosis.Methods We conducted a prospective study with each patient being followed for 4 weeks.A series of 375 consecutive patients with PICCs were selected by convenience sampling and received regular weekly Doppler sonography or angiography for identification of venous thrombosis.Risk factors were identified by statistical analysis,and then scoring model was developed and verified.Results The incidence of PICC-related upper extremity venous thrombosis was 19.2%.Risk factors associated with PICC venous thrombosis following logistic analysis included：obesity,presence of diabetes,history of thrombosis,history of chemotherapy and D-dimer concentration greater than 0.5 mg/L.According to the odds ratio of each factor,the risk scoring model was established and the risk level was rated.The cut-off value of the model was 4.5,and the area under the ROC curve was 0.758.Conclusion The risk scoring model offers a novel way to predict and categorize risk of PICC-related upper extremity venous thrombosis.

关 键 词：PICC 静脉血栓 危险因素 风险模型 超声检查 超声造影 灵敏度 特异度 

分 类 号：R472[医药卫生—护理学]