淋巴瘤植入式静脉输液港患者导管相关性血栓形成的危险因素  

Risk factors for catheter-related thrombosis in patients with lymphoma implanted venous access ports

作　　者：宋菁玲 孙舒君[1] 王子寅[2] Song Qingling;Sun Shujun;Wang Ziyin(Blood Center,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China;Department of Interventional Radiology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院血液中心,上海200025 [2]上海交通大学医学院附属瑞金医院血液中心放射介入科,上海200025

出　　处：《血管与腔内血管外科杂志》2023年第2期184-187,共4页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨淋巴瘤植入式静脉输液港(IVAP)患者导管相关性血栓形成的危险因素。方法收集2018年1月至2022年1月于上海交通大学医学院附属瑞金医院接受IVAP的112例淋巴瘤患者的临床资料,根据是否在首个化疗过程中发生导管相关性血栓将患者分为血栓组和无血栓组,每组56例。分析淋巴瘤IVAP患者导管相关性血栓形成的影响因素。结果血栓组年龄≥65岁、穿刺点为锁骨下静脉、霍奇金淋巴瘤、姑息性化疗的患者比例及血浆D-二聚体(D-D)、血清C反应蛋白(CRP)水平均高于无血栓组,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥65岁、肿瘤类型为霍奇金淋巴瘤、D-D水平高、CRP水平高、化疗类型为姑息化疗均是淋巴瘤IVAP患者导管相关性血栓形成的危险因素(P﹤0.05),穿刺点为颈内静脉是淋巴瘤IVAP患者导管相关性血栓形成的保护因素(P﹤0.05)。结论对于IVAP植入的淋巴瘤患者,应注意监测其凝血功能、血清炎性因子水平,特别是对于肿瘤类型为霍奇金淋巴瘤、年龄较大、D-D水平高、CRP水平高、采用姑息化疗方案的淋巴瘤患者应给予导管相关性血栓预防治疗,以降低导管相关性血栓形成的风险。Objective To investigate the risk factors of catheter-related thrombosis in patients with lymphoma implantable venous access port(IVAP).Method The clinical data of 112 patients with lymphoma who underwent IVAP implantation at Ruijin Hospital,Shanghai Jiaotong University School of Medicine from January 2018 to January 2022 were collected.The patients were divided into thrombosis group and non-thrombosis group based on whether catheterrelated thrombosis occurred during the first chemotherapy,with 56 cases patients in each group.The influencing factors of catheter-related thrombosis in IVAP patients with lymphoma was analyzed.Result The proportion of patients with age≥65 years old,the puncture point being the subclavian vein,Hodgkin lymphoma,palliative chemotherapy,plasma D-D level,and serum CRP level in the thrombus group were higher than those in the non-thrombosis group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that age≥65 years old,Hodgkin lymphoma tumor type,high D-D level high CRP level,and palliative chemotherapy chemotherapy type were all risk factors for catheter-related thrombosis in patients with lymphoma IVAP factors(P<0.05),the puncture point being the jugular vein was a protective factor for catheter-related thrombosis in IVAP patients with lymphoma(P<0.05).Conclusion For lymphoma patients implanted with IVAP,attention should be paid to monitoring their coagulation function and serum inflammatory factor levels,especially for Hodgkin lymphoma,older age,high D-D level,and high CRP level.Lymphoma patients treated with palliative chemotherapy regimens should be given catheter-related thrombosis prophylaxis to reduce the risk of catheter-related thrombosis.

关 键 词：淋巴瘤 植入式静脉输液港 导管相关性血栓 危险因素 保护因素 

分 类 号：R543[医药卫生—心血管疾病]