老年肺癌患者上肢PICC相关性静脉血栓的危险因素及对策研究  

Risk factors and countermeasures of venous thrombosis of upper limbs associated with peripherally inserted central catheter in aged patients with lung cancer

作　　者：黄芳芳 陈雅玫[1] 石新华[1] 尚少梅[2] Huang Fangfang;Chen Yamei;Shi Xinhua;Shang Shaomei(Department of Cancer Chemotherapy and Radiology,Pe king University Third Hospital;School of Nursing,Peking University,Beijing,100191,China)

机构地区：[1]北京大学第三医院肿瘤化疗与放射病科 [2]北京大学护理学院,北京100191

出　　处：《现代临床护理》2023年第4期23-30,共8页Modern Clinical Nursing

基　　金：北京大学第三医院护理种子基金,项目编号为BYSYHL2022008。

摘　　要：目的探讨老年肺癌患者上肢PICC相关性静脉血栓(peripherally inserted central catheters related thrombosis,PICC-CRT)发生的危险因素及其护理措施。方法对2017年1月至2021年1月在某三级甲等综合医院肿瘤科行PICC化疗的287例老年肺癌患者进行一般资料和疾病资料收集,分析其发生PICC-CRT的危险因素。结果老年肺癌化疗患者上肢PICC-CRT发生率为8.7%(25/287)。Logistic回归分析显示,高龄、日常生活活动能力差、头静脉置管、存在营养风险、置管评估为疑难是老年肺癌患者发生上肢PICC-CRT危险因素(均P<0.05),共同解释其33.8%的变异。结论老年肺癌患者上肢PICC-CRT发生率高,医护人员应关注高龄、日常生活活动能力差、存在营养风险、头静脉置管的患者,同时操作者要重视置管前后评估较差的患者,并注重提升自身专业技能水平,采取积极措施预防PICC-CRT的发生。Objective To investigate the risk factors of peripherally inserted central catheter with catheter-related thrombosis(PICC-CRT)in aged patients with lung cancer undergoing intravenous chemotherapy via PICC so as to take proper interventional measures.Methods From January 2017 to January 2021,a total of 287 aged patients with lung cancer who received intravenous chemotherapy through PICC in the Department of Oncology of a tertiary hospital were selected by the convenient sampling method.Medical information were collected and analysed to find out the risk factors of PICC-CRT with the patients.Results The incidence of PICC-CRT among aged patients with lung cancor was 8.7%(25/287).Multivariate analysis showed that the risk factors for the occurrence of PICC-CRT in the upper limbs of the aged patients were advanced age,poor ability of daily activities,cephalic venous catheterisation,nutritional risk and radiotherapist's assessment(all P<0.05),toally explaining 33.8%its variance.Conclusions The incidence of PICC-CRT in upper limbs is high in aged patients with lung cancer.Medical staff should pay attention to the patients with the risk factors(age,poor daily ability,cephahi venous catheterization).Meanwhile,radiotherapists should pay attention to the patients with poor assessments before and after PICC catheterisation.Active measures must be taken to prevent the occurrence of PICC-CRT.Moreover,operators should enhance their professional skills.

关 键 词：老年肺癌患者 经外周静脉穿刺中心静脉置管术相关性血栓 上肢静脉血栓 日常生活活动能力 营养风险 头静脉置管 

分 类 号：R473.73[医药卫生—护理学]