肿瘤患者导管相关性深静脉血栓应用预防性抗凝治疗的临床观察  

Clinical observation of prophylactic anticoagulation for catheter-related deep venous thrombosis in cancer patients

作　　者：蔡夏水 张还珠[1] CAI Xia-Shui;ZHANG Huan-Zhu(Department of Oncology,The First Affiliated of Guangzhou Medical University)

机构地区：[1]广州医科大学附属第一医院肿瘤内科,广州510120

出　　处：《中国肿瘤临床与康复》2021年第2期177-180,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨预防性抗凝治疗对恶性肿瘤患者外周静脉置入中心静脉导管(PICC)后相关性血栓的作用。方法选取2013年1月至2016年12月间广州医科大学附属第一医院收治的系统治疗前予PICC置管的143例患者的临床资料进行回顾性分析,根据治疗方式不同进行分组,其中化疗过程接受预防性抗凝治疗的95例患者纳入预防性抗凝组,仅接受常规治疗不接受任何抗凝治疗的48例患者纳入对照组。探讨两组患者中发生血栓患者的静脉血栓发生情况、置管前后血小板、国际标准化比值(INR)、纤维蛋白原(Fib)及D-二聚体(D-D)。结果143例肿瘤患者发生PICC相关性静脉血栓7例,发生率4.9%,预防性抗凝组95例,发生静脉血栓3例,占3.2%,对照组48例,发生静脉血栓4例,占8.3%。两组患者栓塞发生率比较,差异无统计学意义(P>0.05)。两组患者置管前后血小板、INR、Fib及D-D比较,差异无统计学意义(P>0.05)。结论恶性肿瘤患者PICC置管能增加血栓发生风险,对于置管后的患者应当通过评估患者的全身情况,选择预防血栓形成的措施,降低PICC相关性静脉血栓的发生率,最大限度降低治疗难度,延长生存时间。Objective To study the efficacy of prophylactic anticoagulation on thrombosis associated with peripherally inserted central catheter(PICC)in patients with malignant tumors.Methods From January 2013 to December 2016,the clinical data of 143 patients who underwent PICC surgery at The First Affiliated of Guangzhou Medical University were analyzed retrospectively.Patients were divided into different groups based on the treatment they received.Ninety-five patients receiving prophylactic anticoagulation were included in the prophylactic anticoagulation group and 48 patients receiving conventional treatments without prophylactic anticoagulation were included in a control group.The incidence of deep venous thrombosis,and levels of platelet,international normalized ratio(INR),fibrinogen(Fg)and D-dimer were investigated.Results PICC-associated venous thrombosis occurred in 7 of 143 cancer patients(4.9%),3 of 95 patients receiving prophylactic anticoagulation(3.2%)and 4 patients of 48 patients in the control group(8.3%).There was no significant difference in the incidence of venous thrombosis between the two groups(P>0.05).Moreover,there was no significant difference in the level of platelet,INR,Fg and Ddimer between the two groups(P>0.05).Conclusion Patients with malignant tumors undergoing PICC catheter insertion may have a high risk for thrombosis.systemic monitoring is needed in these patients after the surgery.Furthermore,thromboembolic prophylaxis interventions should be selected to reduce the incidence of PICC-associated venous thrombosis,minimize the treatment difficulty and prolong survival time.

关 键 词：肿瘤 中心静脉导管 血栓 

分 类 号：R730.5[医药卫生—肿瘤]