血栓弹力图预测PICC相关性血栓发生的效能研究  

Research on efficacy of thromoela-stogram in predicting PICC-associated thrombosis

作　　者：高丽霞[1] 李娜[2] 张盼盼[1] 刘长民[1] 王平[3] Gao Lixia;Li Na;Zhang Panpan;Liu Changmin;Wang Ping(Department of Oncology, the Affiliated Hospital of Birizhou Medical College, Binzhou City of Shandong Province 256600 , China;Department of Otolaryngology, the Affiliated Hospital of Binzhou Medical College, Binzhou City of Shandong Province 256600 , China;Department of Infectious Diseases , the Affiliated Hospital of Binzhou Medical College ,Binzhou City of Shandong Province 256600, China)

机构地区：[1]滨州医学院附属医院肿瘤科,山东滨州256600 [2]滨州医学院附属医院耳鼻喉科,山东滨州256600 [3]滨州医学院附属医院感染科,山东滨州256600

出　　处：《国际护理学杂志》2019年第9期1229-1232,共4页international journal of nursing

基　　金：山东省医药卫生科技发展计划(2015WSB30011).

摘　　要：目的研究血栓弹力图(thromoela-stogram, TEG)预测中心静脉置管(peripherally inserted central catheter,PICC)相关静脉血栓发生的效能。方法回顾性分析该院2015年6月1日~2017年6月1日行PICC置管的患者302例,根据是否发生血栓分为血栓组35例和无血栓组267例。通过T或U检验检测PICC置管前后TEG指标变化,筛选预测血栓发生有意义指标,进一步通过受试者工作特征曲线(receiver operating characteristic curve,ROC)评估TEG指标,预测血栓发生的效能。结果不同血栓发生组间χ^2检验结果显示:血栓的发生与高血脂、糖尿病有关,差异均有统计学意义(均P<0.05),与不同年龄、性别、病变部位、是否患有高血压无关,差异均无统计学意义(均P>0.05);血栓组治疗前后r值(反应时间)、K值(凝固时间)、ma值(血栓最大幅度)差异均有统计学意义(均P<0.05),α角度差异无统计学意义(P>0.05);而在非血栓组,r值、K值、ma值、α角度差异均无统计学意义(均P>0.05)。进一步Logistic二元回归分析显示:r值、K值在预测血栓发生有意义(P<0.05),其联合检测ROC曲线下的面积分别为0.819,敏感性84.6%,特异性79.2%,Youden指数>0.242。结论血栓弹力图指标联合预测血栓发生效能明显,值得临床进一步推广应用。Objective To explore the efficacy of thromoela-stogram (TEG) to predict the occurrence of venous thrombosis related to peripherally inserted central catheter (PICC). Methods A retrospective analysis was performed on 302 patients who underwent PICC catheterization in the hospital from June 1, 2015 to June 1, 2017.According to whether there was thrombosis, they were divided into the thrombosis group with 35 cases and the non-thrombosis group with 267 cases.TEG index changes before and after PICC catheterization were detected by T or U test to screen meaningful indicators for predicting thrombosis, and TEG index was further evaluated by receiver operating characteristic curve (ROC) to predict the efficacy of thrombosis. Results The results of χ^2test showed that thrombosis was associated with hyperlipidemia and diabetes mellitus, and the differences were statistically significant(P<0.05). It was not associated with age or sex, and the differences had no statistical significance(P>0.05). The r value (reaction time), K value (coagulation time), ma value (maximum thrombus size) of the thrombus group before and after treatment were statistically significant(P<0.05). There was no significant difference in α Angle(P>0.05). In the non-thrombotic group, there was no significant difference in r value, K value, ma value and α Angle(P>0.05). Further Logistic binary regression analysis showed that r value and K value were significant in predicting thrombosis(P<0.05). The area under the ROC curve was 0.819, the sensitivity was 84.6%, the specificity was 79.2%, and the Youden index was >0.242. Conclusion The efficacy of thrombus elastograms combined with indicators in predicting thrombosis is obvious, which is worthy of further clinical application.

关 键 词：血栓弹力图 PICC 血栓 

分 类 号：R473[医药卫生—护理学]