急性淋巴细胞白血病患儿外周中心静脉导管相关性血栓形成的危险因素  

Risk factors for peripherally inserted central venous catheter-related thrombosis in children with acute lymphoblastic leukemia

作　　者：李雪雁 王纳[1] 谭红菲 LI Xueyan;WANG Na;TAN Hongfei(Third Ward,Department of Pediatric Internal Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,He’nan,China)

机构地区：[1]郑州大学第一附属医院小儿内科三病区,郑州450052

出　　处：《癌症进展》2023年第13期1448-1450,1500,共4页Oncology Progress

摘　　要：目的 探讨急性淋巴细胞白血病(ALL)患儿外周中心静脉导管(PICC)相关性血栓形成的危险因素。方法 根据住院期间是否发生导管相关性血栓(CRT)将568例PICC置管ALL患儿分为血栓组(n=114,发生CRT)和对照组(n=454,未发生CRT)。收集患儿的临床资料,采用多因素Logistic回归模型分析ALL患儿PICC置管后CRT形成的危险因素。结果 PICC置管后CRT发生率为20.1%(114/568)。血栓组中右上臂置管、导管型号﹥3F的患儿比例均明显高于对照组,差异均有统计学意义(P﹤0.01)。PICC置管前后,血栓组患儿的D-二聚体水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。多因素Logistic分析显示,右上臂置管、导管型号﹥3F及置管前D-二聚体水平﹥0.5 mg/L均是ALL患儿PICC置管后CRT形成的独立危险因素(P﹤0.05)。结论ALL患儿PICC置管后CRT发生率较高,右上臂置管、导管型号﹥3F及置管前D-二聚体水平﹥0.5 mg/L均是ALL患儿PICC置管后CRT形成的独立危险因素。Objective To analyze the risk factors of peripherally inserted central venous catheter(PICC)-related thrombosis in children with acute lymphocytic leukemia(ALL).Method According to whether catheter-related thrombosis(CRT)occurred during hospitalization,a total of 568 ALL children treated with PICC were divided into thrombosis group(n=114,occurred CRT)and control group(n=454,not occurred CRT).The clinical data were collected,and risk factors of CRT after PICC in ALL children were analyzed by multivariate Logistic model regression.Result The incidence of CRT after PICC was 20.1%(114/568).The proportion of catheterization in the right upper arm and catheter size>3F in the thrombosis group were significantly higher than those in the control group(P<0.01).Before and after PICC,the D-dimer levels in the thrombosis group were higher than those in the control group(P<0.01).Multivariate Logistic analysis showed that right upper arm catheterization,catheter size>3F,and D-dimer level>0.5 mg/L before catheterization were independent risk factors for CRT after PICC in ALL children(P<0.05).Conclusion The incidence of CRT after PICC is higher,and right upper arm catheterization,catheter size>3F,and D-dimer level>0.5 mg/L before catheterization are independent risk factors for CRT after PICC in ALL children.

关 键 词：儿童 急性淋巴细胞白血病 外周中心静脉导管 导管相关性血栓 

分 类 号：R733.7[医药卫生—肿瘤]