经外周静脉置入中心静脉导管相关性静脉血栓相关的预测模型研究  

Predictive Model Study of Venous Thrombosis Associated with Central Venous Catheter Placement via Peripheral Vein

作　　者：罗君 黎洪群 刘燕[1] 梁芳[1] 李慧 LUO Jun;LI Hong-qun;LIU Yan;LIANG Fang;LI Hui(PICC Outpatient Department of Jiujiang First People's Hospital,Jiujiang 332000,Jiangxi Province,China)

机构地区：[1]九江市第一人民医院PICC门诊,江西九江332000

出　　处：《罕少疾病杂志》2024年第12期135-137,共3页Journal of Rare and Uncommon Diseases

基　　金：江西省卫生健康委科技计划项目(202311490)。

摘　　要：目的构建外周静脉中心静脉导管对相关性静脉血栓的预测模型,旨在为临床预测和早期干预患者提供依据,降低相关性静脉血栓的发生率。方法纳入2021年8月至2022年8月期间我院收治的182例进行PICC置管的患者作为研究对象,根据患者有无PICC置管相关性静脉血栓形成分为血栓组和非血栓组。单因素分析两组一般资料情况,并通过Logistic回归方程进行多因素分析,观察相关性静脉血栓的发生的影响,构建预测方程。结果单因素分析中,血栓组和非血栓组患者在性别、年龄、肥胖、吸烟、饮酒、高血压、手术史、使用抗凝剂、穿刺次数、置入静脉以及置入部位中无差异,P>0.05,而在糖尿病、血栓史、PICC置管史、导管尖端位置以及恶性肿瘤方面有差异,P<0.05。通过Logistic回归方程计算发现糖尿病、血栓史、PICC置管史、导管尖端位置以及恶性肿瘤均是PICC患者相关性静脉血栓发生的影响因素(P<0.05)。血栓组和非血栓组的平均评分分别为(0.081±2.089)分以及(-2.533±1.321)分。两组比较有差异(t=9.546,P<0.05)。ROC曲线下面积(AUC)=0.868,提示该模型能较好地预测相关性静脉血栓的发生。结论PICC患者相关性静脉血栓的影响因素较多,与糖尿病、血栓史、PICC置管史、导管尖端位置以及恶性肿瘤有密切关系。所建立的预测回归模型能较好地预测PICC患者相关性静脉血栓的发生。Objective To study the construction of the prediction model of central venous catheter(PICC)inserted by peripheral vein.Methods 182 patients admitted to our hospital from August 2021 to August 2022 were classified into thrombus and non-thrombus groups according to the presence of PICC catheterization-related venous thrombosis.The risk factors of PICC-related venous thrombosis were identified by the univariate analysis,and brought into the multivariate Logistic regression analysis according to the univariate analysis.Results In univariate analysis,there was no difference in gender,age,obesity,smoking,alcohol consumption,hypertension,surgical history,anticoagulant use,insertion,vein,and placement site(P>0.05),but in diabetes,thrombosis,PICC catheterization,tip location,and malignancy(P<0.05).Univariate differences were included in the multivariate Logistic regression equation,and found that diabetes,thrombosis history,PICC catheterization history,catheter tip location and malignancy were all influencing factors for the occurrence of associated venous thrombosis in PICC patients(P<0.05).The probability of thrombosis in each patient was calculated according to the model,scoring the thrombus and non-thrombus groups,and the ROC curve was drawn.The mean scores were(0.081±2.089)and(-2.533±1.321),respectively.Differdifference between the two groups(t=9.546,P<0.05).The area under the ROC curve(AUC)=0.868 was a good predictive power of the occurrence of associated venous thrombosis in PICC patients.Conclusion There are many factors affecting the related venous thrombosis in PICC patients,such as diabetes mellitus,thrombosis history,PICC catheterization history,catheter tip location,and malignancy.The established predictive regression model can better predict the occurrence of associated venous thrombosis in PICC patients.

关 键 词：中心静脉导管 血栓 预测模型 危险因素 

分 类 号：R543.2[医药卫生—心血管疾病]