超声动态监测恶性肿瘤患者外周静脉穿刺中心静脉置管后上肢深静脉血栓形成风险相关性分析  

Correlation analysis of ultrasound dynamic monitoring of upper limb deep vein thrombosis risk in patients with malignant tumors after peripheral venipentesis central vein catheterization catheterization

作　　者：温馨 赵蕙琳 金壮 刘雨宁 于馨 张筠 WEN Xin;ZHAO Hui-lin;JIN Zhuang;LIU Yu-ning;YU Xin;ZHANG Yun(Department of Ultrasound,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院超声科,辽宁沈阳110016

出　　处：《临床军医杂志》2024年第11期1151-1154,共4页Clinical Journal of Medical Officers

基　　金：辽宁省重点研发计划项目(2020JH2/10300122)。

摘　　要：目的探讨恶性肿瘤患者经外周静脉穿刺中心静脉置管术(PICC)置管后超声动态监测上肢深静脉内有无血栓情况并分析其血栓形成的危险因素。方法回顾性分析自2021年9月至2024年9月于北部战区总医院肿瘤科行PICC治疗的156例恶性肿瘤患者的临床资料。根据超声检查PICC置管后上肢深静脉内有无血栓将患者分为有血栓组(n=42)与无血栓组(n=114)。通过病例查询系统收集患者的一般资料、超声检查指标及实验室检查指标,并对其变量进行分类,再采用多因素Logistic回归分析PICC置管后上肢深静脉血栓形成(UEDVT)的危险因素。结果两组患者的年龄、化疗次数、静脉血流速度,以及肿瘤的类型比较,差异均有统计学意义(P<0.05)。将单因素分析出影响患者PICC置管后UEDVT有差异的指标进行多因素分析,结果显示,恶性肿瘤患者的化疗次数及静脉的血流速度的快慢是影响PICC置管后UEDVT的独立危险因素(P<0.05)。结论恶性肿瘤患者的化疗次数及静脉的血流速度的快慢是影响UEDVT的独立危险因素。血管二维及彩色多普勒超声检查可作为动态监测PICC置管后是否存在UEDVT的首选检查方法,有助于临床评估和制定个体化预后治疗方案。Objective To investigate the dynamic monitoring of thrombosis in the deep vein of upper limb and analyze the risk factors of thrombosis in malignant tumor patients after peripheral venipentesis central vein catheterization(PICC).Methods The clinical data of 156 patients with malignant tumors treated with PICC in Department of Oncology in General Hospital of Northern Theater Command from September 2021 to September 2024 were retrospectively analyzed.After PICC catheterization,the patients were divided into the thrombus group(n=42)and the thrombus group(n=114).General data,ultrasound examination indicators and laboratory examination indicators of patients were collected through the case query system,and their variables were classified,and multivariate Logistic regression was used to analyze the risk factors of upper extremity deep venous thrombosis(UEDVT)after PICC catheterization.Results There were statistically significant differences in age,frequency of chemotherapy,venous blood flow velocity and tumor type between the two groups(P<0.05).Multivariate analysis was carried out to identify the indicators affecting the difference in UEDVT after PICC catheterization.The results showed that the frequency of chemotherapy and the speed of venous blood flow in malignant tumor patients are independent risk factors affecting UEDVT after PICC catheterization(P<0.05).Conclusion The frequency of chemotherapy and the speed of venous blood flow in patients with malignant tumor are independent risk factors affecting UEDVT.Vascular 2D and color Doppler ultrasonography can be used as the first choice to dynamically monitor the presence of UEDVT after PICC catheterization,which is helpful for clinical evaluation and individualized prognostic treatment.

关 键 词：二维超声 彩色多普勒超声 经外周静脉穿刺中心静脉置管 上肢静脉血栓形成 危险因素 

分 类 号：R730[医药卫生—肿瘤]