上臂型输液港肿瘤患者并发CRT的危险因素分析  

Risk factors analysis for complication of CRT in oncology patients with upper arm-type infusion port

作　　者：黄秀艳[1] 陈湘威[1] 杨晋杰 HUANG Xiuyan;CHEN Xiangwei;YANG Jinjie(The Third Affi liated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院,广东省广州市510630

出　　处：《护理实践与研究》2024年第4期536-542,共7页Nursing Practice and Research

基　　金：广东省卫生健康委员会医学科研基金项目(编号:A2021029)。

摘　　要：目的 探讨上臂型输液港肿瘤患者发生导管相关性血栓(CRT)的危险因素,为临床护理方案制定提供一定参考依据。方法 选取医院2021年2月—2022年2月收治120例上臂型输液港肿瘤患者为研究对象,将其中36例发生CRT患者作为病例组,84例未并发CRT患者作为对照组。通过问卷调查的方式收集患者基本资料及导管相关性血栓发生情况;通过单因素分析、多因素Logistic回归分析,探讨上臂型输液港肿瘤患者发生导管相关性血栓的危险因素。结果 现状调查结果显示,本研究36例CRT患者中,症状性血栓9例,无症状性血栓27例。单因素及多因素Logistic回归分析结果显示,患者年龄≥60岁、BMI指数越高、肿瘤分期为Ⅲ~Ⅳ期、TC水平越高、FIB越高、D-二聚体水平越高、上臂输液港肿瘤患者并发CRT风险越高(P<0.05)。结论 CRT为上臂型输液港肿瘤患者常见并发症,其发生将增加患者的治疗成本,并给治疗带来额外的负担,本研究经过调查发现,上臂型输液港肿瘤患者中以无症状性血栓最为多见。且本研究多因素回归分析显示,患者年龄、BMI指数、肿瘤分期、TC水平、FIB水平、D-二聚体水平为上臂输液港肿瘤患者并发CRT的独立危险因素,提示临床应重视以上因素的评估,做好基础性护理干预,包括密切监测患者症状、采取抗凝治疗、保持导管和周围区域的清洁等,并参考相应管理指南制订相应的防护方案,以降低上臂型输液港肿瘤患者CRT发生风险,保障患者治疗有效性和持续性。Objective To explore the risk factors of catheter-related thrombosis(CRT)in patients with upper arm infusion port tumors,to provide a certain reference basis for the development of clinical nursing program.Methods 120 patients with upper arm-type infusion port tumors admitted to the hospital from February 2021 to February 2022 were selected as the study subjects,36 patients with CRT occurence were set as the case group and 84 patients without CRT Occurence as the control group.The basic data of the patients and the occurrence of catheter-related thrombosis were collected by the questionnaires,the risk factors for the occurrence of catheter-related thrombosis in patients with upper arm-type infusion port tumors were explored by means of univariate analysis and multifactorial Logistic regression analysis.Results The results of the present investigation showed that among 36 CRT patients in this study,there were 9 cases of symptomatic thrombosis and 27 cases of asymptomatic thrombosis.The results of unifactorial and multifactorial Logistic regression analyses showed that patients'age≥60 years,higher BMI,tumor stage III-IV,higher TC level,higher FIB,higher D-dimer level,and higher risk of concurrent CRT in patients with tumors in the port of the upper arm infusion(P<0.05).Conclusion CRT is a common complication in patients with upper arm-type infusion port tumors,and its occurrence will increase the cost of treatment for patients and bring additional burden for treatment,the study found that asymptomatic thrombosis was most common in patients with upper arm-type infusion port tumors after investigation.Moreover,multifactorial regression analysis in this study showed that patients age,BMI,tumor stage,TC level,FIB level,and D-dimer level were independent risk factors for the complication of CRT in patients with upper arm infusion port tumors,suggesting that clinics should pay attention to the assessment of the above factors and fully applied the basic nursing interventions,including close monitoring of patients'sympto

关 键 词：上臂型输液港 肿瘤 导管相关性血栓 危险因素 使用寿命 

分 类 号：R473.73[医药卫生—护理学]