出血性脑卒中患者PICC深静脉血栓形成的影响因素分析  

Analysis of Influencing Factors on PICC Deep Vein Thrombosis in Patients with Hemorrhagic Stroke

作　　者：唐艳丽 陈剑琴 TANG Yan-li;CHEN Jian-qin(Nursing Department of Changde Hospital Affi liated to Xiangya Medical College,Central South University,Changde Hunan 415003,China;Outpatient Offi ce of Changde Hospital Affi liated to Xiangya Medical College,Central South University,Changde Hunan 415003,China)

机构地区：[1]中南大学湘雅医学院附属常德医院护理部,湖南常德415003 [2]中南大学湘雅医学院附属常德医院门诊办公室,湖南常德415003

出　　处：《中华养生保健》2025年第7期119-122,共4页CHINESE HEALTH CARE

基　　金：常德市科技创新指导性计划项目(2022ZD41)。

摘　　要：目的了解出血性脑卒中患者经外周静脉置入中心静脉导管(Peripherally Inserted Central Catheters,PICC)置管后深静脉血栓形成的影响因素。方法本研究采用回顾性分析方法,选取2021年1月—2023年12月常德市第一人民医院收治的235例行PICC的出血性脑卒中患者的临床资料。根据深静脉血栓是否形成分为发生组(n=34)和未发生组(n=201),分析两组患者年龄、性别、置管时Wells评分、置管时Caprini评分、置管时格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分、置管部位肌力、置管前D-二聚体、置管前血浆纤维蛋白原、置管前凝血酶时间,置管后动态复查四肢深静脉彩超。结果235例出血性脑卒中患者行PICC置管后34例形成深静脉血栓,发生率为14.5%;两组患者性别、置管时Caprini评分、置管时GCS评分、置管部位肌力、置管前血浆纤维蛋白原、置管前凝血酶时间比较,差异均无统计学意义(P>0.05);两组患者年龄、置管时Wells评分、置管前D-二聚体比较,差异有统计学意义(P<0.05)。结论年龄过高、置管时Wells评分低、置管前D-二聚体水平高会增加出血性脑卒中患者PICC置管后相关性静脉血栓的发生率,对于此类患者置管后应该积极预防深静脉血栓的发生,及时动态复查四肢深静脉彩超,必要时予以深静脉置管代替PICC。Objective Understand the infl uencing factors of deep vein thrombosis in patients with hemorrhagic stroke after PICC catheterization.Methods This study used a retrospective analysis method to analyze the clinical data of 235 PICC patients with hemorrhagic stroke admitted to the First People's Hospital of Changde City from January 2021 to December 2023.According to the formation of deep vein thrombosis,patients were divided into two groups:occurrence group(34 cases)and non occurrence group(201 cases).The age,gender,Wells score at catheterization,Caprini score at catheterization,Glasgow Coma Scale(GCS)score at catheterization,muscle strength at catheterization site,D-dimer before catheterization,plasma fi brinogen before catheterization,and thrombin time before catheterization were analyzed for both groups.Four limb deep vein ultrasound was dynamically re examined after catheterization.Results Among 235 patients with hemorrhagic stroke,34 developed deep vein thrombosis after PICC catheterization,with an incidence rate of 14.5%;There was no statistically signifi cant diff erence between the two groups in terms of patient gender,Caprini score at catheterization,GCS score at catheterization,muscle strength at catheterization site,plasma fi brinogen before catheterization,and thrombin time before catheterization(P>0.05);There were statistically signifi cant diff erences between the two groups in patient age,Wells score at catheterization,and D-dimer before catheterization(P<0.05).Conclusion Being too old,having a low Wells score during catheterization,and having high levels of D-dimer before catheterization can increase the incidence of related venous thrombosis in patients with hemorrhagic stroke after PICC catheterization.For such patients,active prevention of deep vein thrombosis should be taken after catheterization,and dynamic ultrasound examinations of the deep veins in the limbs should be conducted in a timely manner.If necessary,deep vein catheterization should be used instead of PICC.

关 键 词：出血性脑卒中 PICC相关性静脉血栓 临床特点 

分 类 号：R743.3[医药卫生—神经病学与精神病学]