预充式导管冲洗器用于肺癌晚期患者PICC置管后血栓性静脉炎的效果评价  

Evaluation of Clinical Effect of Pre-filled Catheter Irrigator on Thrombophlebitis after Central Venous Catheterization in Patients with Advanced Lung Cancer

作　　者：申莉莉 高学农 赖翔宇 张炀 张晓宇 SHEN Lili;GAO Xuenong;LAI Xiangyu;ZHANG Yang;ZHANG Xiaoyu(Affiliated Renhe Hospital of China,Three Gorges University,Yichang Hubei 443001,China;Chongqing University Cancer Hospital,Chongqing 400030,China;Yangjiaping Street Community Health Service Center,Jiulongpo District,Chongqing 400050,China)

机构地区：[1]三峡大学附属仁和医院,湖北宜昌443001 [2]重庆大学附属肿瘤医院,重庆400030 [3]重庆市九龙坡区杨家坪街道社区卫生服务中心,重庆400050

出　　处：《西南大学学报(自然科学版)》2025年第3期161-167,共7页Journal of Southwest University(Natural Science Edition)

基　　金：重庆市科卫联合医学科研项目(2021MSXM171);肿瘤微环境与免疫治疗湖北省重点实验室项目(2022KEL1-04)。

摘　　要：探讨预充式导管冲洗器对经外周静脉置入中心静脉导管(PICC)后相关性血栓性静脉炎的发生情况及炎症和凝血相关因子的表达情况,选取2021年6月至2022年1月于重庆大学附属肿瘤医院肿瘤放射治疗中心收治的肺癌晚期患者100例,随机分为实验组和对照组,实验组行预充式导管冲洗器冲洗PICC,对照组采取传统手工冲洗PICC;观察置管前(Pre)、手冲式PICC置管后1 d(T1)、置管后30 d(T2)、置管后90 d(T3)以及预充式PICC置管后1 d(MT1)、置管后30 d(MT2)、置管后90 d(MT3)相关静脉炎的发生情况、渗出情况;同时测定血浆中凝血相关蛋白血栓相关因子血栓调节蛋白(TM)、抗凝血酶Ⅲ(ATⅢ)、血浆D-二聚体(D2D)、纤维蛋白原相关蛋白1(FGL1)以及炎症性细胞因子肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)的含量变化。结果显示:相较于PICC置管前,PICC置管后实验组和对照组静脉炎和渗出的发生率均明显增加,TM、ATⅢ及D2D水平显著降低,TNF-α、IL-1β含量显著升高(p<0.05);与对照组相比,PICC置管后实验组静脉炎和渗出的发生率明显降低,同时IL-1β等因子浓度显著降低(p<0.05)。综合表明:预充式冲洗明显降低了PICC导致的患者血栓性静脉炎的发生,该作用与其抑制血栓相关因子和炎症因子水平有关。To investigate the incidence of post peripherally inserted central catheter(PICC)related phlebitis and its effect on the expression of inflammation and coagulation-related factors.A total of 100 patients with advanced lung cancer admitted to the Department of Radiotherapy,Chongqing Cancer Hospital from June 2021 to January 2022 were randomly divided into two groups:manual washing catheter washed PICC(T)and disposable pre-filled washing catheter washed PICC(MT).The incidence of phlebitis before irrigation(Pre),and 1(T1/MT1),30(T2/MT2)90(T3/MT3)days after irrigation was observed.The concentrations of coagulation-related proteins thrombomodulin(TM),antithrombin Ⅲ(ATⅢ),plasma D-dimer(D2D),fibrinogen associated protein 1(FGL1)and inflammation-related factors tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in fasting plasma were measured by radioimmunoassay before and after irrigation.The incidence of phlebitis and exudation increased significantly after PICC catheterization.Compared with before catheterization,in both groups,the levels of TM,ATⅢ and D2D were significantly decreased,and the contents of TNF-α and IL-1β were significantly increased after PICC catheterization(p<0.05).Compared with manual-rinsed PICC group,the incidence of phlebitis and exudation of PICC in disposable pre-filled rinsing group decreased,while IL-1β and other factors decreased significantly(p<0.05).Disposable pre-filled rinsing can significantly reduce the incidence of thrombophlebitis in patients by PICC,which is related to the inhibition of thrombus-related factors and inflammatory factors.

关 键 词：中心静脉导管 血栓性静脉炎 预充式导管冲洗器 肺癌患者 

分 类 号：R965.1[医药卫生—药理学] R975.5[医药卫生—药学]