Autar量表在预防乳腺癌术后化疗置管侧上肢静脉血栓形成中的应用效果  

Application effect of Autar scale on the prevention of upper extremity venous thrombosis on the catheterization side in postoperative chemotherapy for breast cancer

作　　者：王芳 马晓蕾 石心茹 梁斌 Wang Fang;Ma Xiaolei;Shi Xinru;Liang Bin(Department of Emergency,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China;Hospital Infection Office,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China;Department of Internal Intensive Care Medicine,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China;Department of Mammary Gland,Zhangjiakou First Hospital,Zhangjiakou 075000,Hebei,China)

机构地区：[1]张家口市第一医院急诊科,河北张家口075000 [2]张家口市第一医院院感办,河北张家口075000 [3]张家口市第一医院内科重症医学科,河北张家口075000 [4]张家口市第一医院乳腺科,河北张家口075000

出　　处：《血管与腔内血管外科杂志》2024年第8期968-973,共6页Journal of Vascular and Endovascular Surgery

基　　金：河北省卫生健康委员会2022年计划项目(20221887)。

摘　　要：目的探讨Autar量表在预防乳腺癌术后化疗置管侧上肢静脉血栓形成中的应用效果。方法选取2020年8月至2023年8月于张家口市第一医院接受乳腺癌术后化疗并经外周静脉置入中心静脉导管的80例患者,按照简单随机抽样法分为观察组和对照组,每组40例。对照组患者实施常规干预措施,观察组患者在对照组的基础上采取基于Autar量表评估的分级干预措施。比较两组患者置管后机械性静脉炎、非计划拔管的发生率,置管前、置管后3 d凝血功能指标[D-二聚体(D-D)、纤维蛋白原(FIB)水平]和血流动力学指标,置管后7d置管侧上肢静脉血栓的发生率,以及置管前、置管后3个月生活质量评分[世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分]。结果观察组患者置管后机械性静脉炎、非计划拔管发生率均略低于对照组患者,但差异均无统计学意义(P﹥0.05)。置管后3 d,两组患者的D-D、FIB水平均高于本组置管前,血流平均速度、血流峰速度均低于本组置管前,且观察组患者的D-D、FIB水平均低于对照组患者,血流平均速度、血流峰速度均高于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者置管侧上肢近端、远端静脉血栓的发生率均低于对照组患者,差异均有统计学意义(P﹤0.05)。置管后3个月,两组患者WHOQOL-BREF中的各维度评分均高于本组置管前,且观察组患者WHOQOL-BREF中的各维度评分均高于对照组患者,差异均有统计学意义(P﹤0.05)。结论基于Autar量表评估的分级干预措施在乳腺癌化疗置管患者中的应用效果显著,可有效改善患者的凝血功能指标和血流动力学指标,降低置管侧上肢静脉血栓形成的发生率,提高患者的生活质量。Objective To investigate the application effect of Autar scale on the prevention of upper extremity venous thrombosis on the catheterization side in postoperative chemotherapy for breast cancer.Method A total of 80 patients who received postoperative chemotherapy for breast cancer and peripherally inserted central venous catheter in Zhangjiakou First Hospital from August 2020 to August 2023 were selected.They were divided into observation group and control group according to simple random sampling method,with 40 cases in each group.The patients of control group were given routine clinical intervention measures,while the patients of observation group carried out graded intervention measures of Autar scale evaluation on this basis.The incidence rate of mechanical phlebitis and unplanned extubation after catheterization,as well as coagulation function indicators[D-dimer(D-D),fibrinogen(FIB)]and hemodynamic indicators before and 3 days after catheterization,the incidence of upper extremity venous thrombosis on the catheterization side 7 days after catheterization,and the quality of life scores[World Health Organization quality of life-BREF(WHOQOL-BREF)scores]before and 3 months after catheterization were compared between the two groups.Result The incidence of mechanical phlebitis and unplanned extubation after catheterization in the observation group were slightly lower than those in the control group,but the differences were not statistically significant(P>0.05).After 3 days of catheterization,the levels of D-D and FIB in both groups of patients were higher than before catheterization,and the average blood flow velocity and peak blood flow velocity were lower than before catheterization.In addition,the levels of D-D and FIB in the observation group were lower than those in the control group,and the average blood flow velocity and peak blood flow velocity were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of venous thrombosis in the proximal and distal upp

关 键 词：Autar量表 乳腺癌 术后化疗 置管 上肢深静脉血栓形成 生活质量 

分 类 号：R543[医药卫生—心血管疾病]