经外周中心静脉置管化疗后置管侧上肢静脉血栓形成分析及对策

发布时间：2018-10-09 08:37

【摘要】：目的分析恶性肿瘤患者经外周中心静脉置管(PICC)化学治疗后置管侧上肢静脉血栓发生原因并提出防治对策。方法观察160例经PICC化疗的不同恶性肿瘤患者置管侧上肢静脉血栓发生数及发生时间,分析血栓形成的可能原因并提出防治对策。结果本组共发生置管侧上肢静脉血栓4例,其中肺肿瘤患者2例,胃肠道肿瘤患者2例。PICC上肢静脉血栓发生率2.5%。血栓发生时间多数在化疗后7~14 d。结论 PICC化疗后,7~14 d是置管侧上肢静脉血栓发生的高危期。肿瘤及化疗药物、穿刺血管损伤、导管头端异位、上肢活动是血栓形成的主要原因。因此,合理地选择穿刺血管、准确定位,肿瘤患者治疗全过程的严密观察和化疗后凝血指标的监控,以及出院后的随访,能够有效预防置管侧上肢静脉血栓的发生。
[Abstract]:Objective to analyze the causes of venous thrombosis in the upper limb of patients with malignant tumor treated with (PICC) via peripheral central vein catheter and put forward the preventive and therapeutic measures. Methods the number and time of venous thrombosis in upper limb of 160 patients with different malignant tumors treated with PICC chemotherapy were observed and the possible causes of thrombosis were analyzed and the preventive and therapeutic measures were put forward. Results there were 4 cases of venous thrombosis in the upper limb, 2 cases of pulmonary tumor and 2 cases of gastrointestinal tumor. The incidence of PICC venous thrombosis in upper limb was 2.5%. Most of the thrombus occurred at 7 ~ 14 days after chemotherapy. Conclusion 14 days after PICC chemotherapy is a high risk period for venous thrombosis in the upper limb. Tumor and chemotherapeutic drugs, puncture vascular injury, ectopic of catheter head and end, and upper limb activity are the main causes of thrombosis. Therefore, a reasonable selection of puncture vessels, accurate location, close observation of the whole process of tumor treatment, monitoring of coagulation indexes after chemotherapy, and follow-up after discharge can effectively prevent the occurrence of venous thrombosis in the upper limb of the catheterized side.
【作者单位】：江苏省苏北人民医院肿瘤科;
【分类号】：R473.73

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