老年急性髓系白血病患者经外周静脉穿刺中心静脉置管后上肢深静脉血栓的危险因素分析何晓蓉,罗婷,王婷  

Analysis of risk factors for upper extremity deep vein thrombosis in elderly patients with acute myeloid leukemia after peripherally inserted central catheter

作　　者：何晓蓉 罗婷 王婷 He Xiaorong;Luo Ting;Wang Ting(Department of Hematology,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu,Sichuan,610041,P.R.China)

机构地区：[1]四川大学华西医院血液内科/四川大学华西护理学院,四川成都610041

出　　处：《老年医学与保健》2024年第3期616-620,共5页Geriatrics & Health Care

基　　金：四川省科技计划项目(2023YFS0188)。

摘　　要：目的分析老年急性髓系白血病患者经外周静脉穿刺中心静脉置管(PICC)后发生上肢深静脉血栓(DVT)的危险因素。方法回顾性分析2020年8月—2022年8月于四川大学华西医院收治的315例老年急性髓系白血病PICC患者的临床资料,依据患者是否发生DVT分为DVT组(87例)和非DVT组(228例)。比较2组一般资料、总胆固醇(TC)值、高密度脂蛋白(HDL)值、低密度脂蛋白(LDL)值、凝血酶原时间(PT-SEC)、凝血酶原时间国际标准化比值(PT-INR)、部分活化凝血酶原时间(APTT)、纤维蛋白原(FIB)值、凝血酶时间(TT),并进一步采用Logistic回归方法分析其影响因素。结果2组性别、住院时间、BMI、近期手术史、血栓史、高血压、糖尿病、吸烟或饮酒、置管时间、穿刺部位等一般资料差异均无统计学意义(P>0.05);DVT组年龄、穿刺静脉血管中头静脉比例、化疗相关性出血比例大/高于非DVT组(P<0.05);2组TC、HDL、LDL、PT-SEC、PT-INR、APTT、FIB、TT指标值差异均无统计学意义(P>0.05);Logistic分析结果显示,年龄增加、穿刺静脉血管中头静脉比例升高、化疗相关性出血比例升高为PICC后发生DVT的危险因素(P<0.05)。结论老年急性髓系白血病患者PICC后DVT的发生与年龄、穿刺头静脉、化疗相关性出血可能有关,值得临床重视。Objective To investigate the risk factors for upper limb deep venous thrombosis(DVT)in elderly patients with acute myeloid leukemia after peripherally inserted central catheter(PICC).Methods The clinical data of 315 elderly patients with acute myeloid leukemia who underwent PICC in West China Hospital of Sichuan University from August 2020 to August 2022 were retrospectively analyzed.They were divided into DVT group(87 cases)and non-DVT group(228 cases)according to whether they had DVT.The general data,total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),prothrombin time in seconds(PT-SEC),prothrombin time/international normalized ratio(PT-INR),activated partial thromboplastin time(APTT),fibrinogen(FIB)and thrombin time(TT)were compared between the two groups.Logistic regression analysis was performed to screen the influencing factors.Results There was no statistically significant difference between the two groups in gender,length of hospital stay,BMI,recent surgical history,thrombosis history,hypertension,diabetes,smoking or drinking,time of catheterization,puncture site and other general information(P>0.05).The age,proportion of cephalic vein in puncture veins,and proportion of chemotherapy-related bleeding in the DVT group were higher than those in the non-DVT group(P<0.05).There was no statistically significant difference in TC,HDL,LDL,PT-SEC,PT-INR,APTT,FIB and TT between the two groups(P>0.05).The Logistic analysis results showed that increasing age,cephalic vein puncture,and chemotherapy-related bleeding were risk factors for DVT after PICC(P<0.05).Conclusion The occurrence of DVT after PICC in elderly patients with acute myeloid leukemia may be related to age,cephalic vein puncture and chemotherapy-related bleeding,which is worthy of clinical attention.

关 键 词：老年 急性髓系白血病 经外周静脉穿刺中心静脉置管 上肢深静脉血栓 

分 类 号：R733.71[医药卫生—肿瘤]