摘要
目的 探讨肺癌患者经外周静脉置入中心静脉导管（PICC）导管相关性血栓的风险预警管理,以提高肺癌患者PICC置管的有效性和安全性.方法 将2012年1月至2013年12月在上海市胸科医院进行PICC置管的肺癌患者761例作为观察组,运用Autar量表对置管患者进行血栓风险评估,根据风险评估将患者分为低风险组332例、中风险组364例和高风险组65例,3组患者给予分级护理干预,低风险组和中风险组给予物理干预、基本药物干预;对高风险组物理干预、基本药物干预和紧急干预.将2008年1月至2011年12月置管的873例肺癌PICC置管患者作为对照组.结果 对照组873例置管患者发生32例PICC导管相关性血栓,血栓发生率为3.66％.观察组患者发生PICC相关血栓12例,发生率1.58％,显著低于对照组（P =0.009）.其中低风险组、中风险组和高风险组患者血栓发生率分别为1.51％（5例）、1.37％（5例）和1.54％（1例）;所有患者均未发生肺栓塞.结论 运用风险预警管理可以降低高凝状态肺癌患者PICC导管相关性血栓等并发症的发生.
Objective To evaluate the effect of risk early warning management in preventing peripherally inserted central catheter （PICC）-related thrombosis in lung cancer patients,in order to improve the efficacy and safety of PICC application in lung cancer patients.Methods A total of 761 patients receiving PICC in Shanghai Chest Hospital between January 2012 and December 2013 were observed.Based on the assessment of PICC-related thrombosis risk using Autar scale,the patients were divided into 3 groups,namely low risk group （n =332）,medium risk group （n =364）,and high risk group （n =65）.Patients in the 3 groups were given grading nursing intervention,physical intervention and basic drug intervention for low and medium risk groups,compared with physical intervention,basic drug intervention plus emergency intervention for high risk group.873 lung cancer patients with PICC in the period from January 2008 to December 2011 served as controls.Results 32 cases in the control group （3.66％） developed PICC-related thrombosis,compared with 12 cases in the observation group （1.58％） （P =0.009）.The incidence of PICC-related thrombosis was 1.51％ （5/ 332）,1.37％ （5/364）,and 1.54 （1/65） in low,medium,and high risk groups,respectively.None of the patients developed pulmonary embolism.Conclusion Risk early warning management can help reduce the risk of PICC-related thrombosis in lung cancer patients in hypercoagulable state.
出处
《中华临床营养杂志》
CAS
CSCD
2014年第5期313-316,共4页
Chinese Journal of Clinical Nutrition
基金
上海交通大学附属胸科医院院级管理项目
关键词
评估
血栓
预防
Assessment
Thrombosis
Prevention
