同步放化疗患者PICC相关性静脉血栓形成影响因素分析  

Risk factors of venous thrombosis associated with PICC among cancer patients undergoing concurrent radio-chemotherapy

作　　者：郑美花[1] 黄凤凤[1] 王璐祯 ZHENG Mei-hua;HUANG Feng-feng;WANG Lu-zhen(Department of General Surgery,Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,P.R.China)

机构地区：[1]福建医科大学附属第二医院普外科

出　　处：《中华肿瘤防治杂志》2019年第21期1637-1641,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的经外周静脉置入中心静脉导管(peripherally inserted central catheters,PICC)是肿瘤患者常见的给药通路,肿瘤本身及抗肿瘤治疗会增加PICC导管相关性静脉血栓的发生率。本研究探讨同步放化疗患者PICC导管相关性静脉血栓与不同放疗部位、行为状态评分(Karnofsky Performance Status,KPS)等因素的关系。方法回顾性分析福建医科大学附属第二医院2015-03-12-2018-10-30收治的465例留置PICC导管同步放化疗患者的临床资料,探讨同步放化疗患者PICC导管相关性静脉血栓的危险因素,对血栓发生的相关因素进行二元Logistic回归分析。结果 465例同步放化疗患者中,PICC导管相关性静脉血栓发生率为9.68%(45/465)。其中有症状性血栓11例,无症状性血栓34例。放疗部位为胸部(OR=4.722,95%CI:2.185~7.963)及头颈部(OR=2.554,95%CI:1.983~4.674)、肿瘤Ⅲ~Ⅳ期(OR=2.841,95%CI:1.866~3.624)和KPS评分≤50(OR=2.048,95%CI:1.273~3.891)是同步放化疗患者PICC导管相关性静脉血栓发生的独立危险因素。结论胸部及头颈部放疗、肿瘤Ⅲ~Ⅳ期和KPS评分≤50是同步放化疗患者PICC导管相关性静脉血栓形成的危险因素,置管之前有必要根据不同放疗部位和肿瘤分期及患者KPS评分充分评估,为建立有效风险预警管理措施提供临床依据。OBJECTIVE Peripheral inserted central catheters(PICC)is a common drug delivery pathway for cancer patients.Tumor itself and antineoplastic therapy can increase the incidence of PICC catheter-related venous thrombosis.The aim of the study was to analyze the relationship between PICC catheter-related venous thrombosis in patients undergoing concurrent radio-chemotherapy and different radiotherapy sites,Karnofsky Performance Status(KPS)and other factors.METHODS A retrospective analysis was made of the clinical data of 465 patients treated with PICC catheter synchronous radiotherapy and chemotherapy in the Second Affiliated Hospital of Fujian Medical University from March 12 th,2015 to October 30 th,2018.The risk factors of PICC catheter-related venous thrombosis in patients undergoing concurrent radio-chemotherapy were analyzed.The related factors of thrombosis were analyzed by binary logistic regression.RESULTS PICC catheter-related venous thrombosis occurred in 45 of the 465 patients with concurrent radiotherapy and chemotherapy,with an incidence of 9.68%,including 11 patients with symptomatic thrombosis and 34 patients with asymptomatic thrombosis.The radiotherapy site was chest(OR=4.722,95%CI:2.185-7.963)and head and neck(OR=2.554,95%CI:1.983-4.674),tumorⅢ-Ⅳ (OR=2.841,95%CI:1.866-3.624)and KPS score≤50(OR=2.048,95%CI:1.273-3.891)were independent risk factors for PICC catheter-related venous thrombosis in patients undergoing concurrent radio-chemotherapy.CONCLUSIONS Chest and head and neck radiotherapy,stage Ⅲ-Ⅳ of tumors,and KPS score≤50 are risk factors for PICC catheter-related venous thrombosis in patients undergoing concurrent radio-chemotherapy.It is necessary to fully evaluate the different radiotherapy sites,tumor stages and KPS score of patients before catheterization,so as to provide clinical basis for establishing effective risk early warning management measures.

关 键 词：同步放化疗 经外周静脉置入中心静脉导管 静脉血栓栓塞 

分 类 号：R47[医药卫生—护理学]