胃肠道恶性肿瘤病人PICC相关性上肢静脉血栓形成的危险因素及预测价值分析  

Risk factors and predictive value of PICC-related upper limb venous thrombosis in patients with gastrointestinal malignancies

作　　者：焦蕊蕊 JIAO Ruirui(Henan Cancer Hospital/Affiliated Cancer Hospital of Zhengzhou University,Henan 450000 China)

机构地区：[1]河南省肿瘤医院、郑州大学附属肿瘤医院,450000

出　　处：《全科护理》2023年第32期4585-4590,共6页Chinese General Practice Nursing

摘　　要：目的:探讨胃肠道恶性肿瘤病人经外周静脉置入中心静脉导管(PICC)相关性上肢静脉血栓形成的危险因素,并分析相关因素的预测价值及临界值。方法:选取医院2018年1月-2022年10月通过PICC实施化疗的500例胃肠道恶性肿瘤病人为研究对象,根据PICC相关性上肢静脉血栓形成与否分为血栓组和非血栓组,分析PICC相关性上肢静脉血栓形成的危险因素。结果:PICC相关性上肢静脉血栓发生率7.80%。二元Logistic回归分析结果显示,血栓史、既往PICC置管史、导管/静脉内径比例(C/V)和置管前血浆D-二聚体水平是胃肠道恶性肿瘤病人PICC相关性上肢静脉血栓形成的独立危险因素(P<0.05);ROC曲线分析结果显示,C/V和置管前血浆D-二聚体水平的临界值分别为0.375和0.475 mg/L。结论:胃肠道恶性肿瘤病人PICC相关性上肢静脉血栓发生率较高,血栓史、既往PICC置管史、C/V和置管前血浆D-二聚体水平是胃肠道恶性肿瘤病人PICC相关性上肢静脉血栓形成的独立预测因子。有利于临床筛查高危病人,并及时给予必要的干预措施,降低PICC相关性上肢静脉血栓发生率。Objective:To analyze the risk factors of PICC-related upper limb venous thrombosis in patients with gastrointestinal malignant tumors,and analyze the predictive value and critical value of relevant factors.Methods:A total of 500 patients with gastrointestinal malignant tumors who received chemotherapy through PICC from January 2018 to October 2022 were selected as the study objects.The patients were divided into thrombus group and non-thrombus group according to whether PICC-related upper limb venous thrombosis had occurred,and the risk factors of PICC-related upper limb venous thrombosis were analyzed.Results:The incidence of PICC-related upper limb venous thrombosis was 7.80%.Binary Logistic regression analysis showed that history of thrombosis,previous PICC catheterization history,catheter/vein diameter ratio(C/V)and plasma D-dimer level before catheterization were independent risk factors for PICC-related upper limb venous thrombosis in patients with gastrointestinal malignancies(P<0.05).ROC curve analysis showed that the critical values of C/V and plasma D-dimer level before catheterization were 0.375 mg/L and 0.475 mg/L,respectively.Conclusions:The incidence of PICC-related upper limb venous thrombosis is higher in patients with gastrointestinal malignancies.History of thrombosis,previous PICC catheterization history,C/V and plasma D-dimer level before catheterization are independent predictors of PICC-related upper limb venous thrombosis in patients with gastrointestinal malignancies.It is beneficial for clinical screening of high-risk patients and timely giving necessary intervention measures to reduce the incidence of PICC-related upper limb venous thrombosis.

关 键 词：胃肠道恶性肿瘤 PICC相关性上肢静脉血栓 危险因素 

分 类 号：R473.73[医药卫生—护理学]