上肢深静脉血栓症与外围插入的中央导管有关,在住院外科手术患者中
Nick Li1, Paul Njoku2, Amit K J Mandal3
1Surgery, The Queen's College, University of Oxford, Oxford, GBR.
Cureus
|January 8, 2025
概括
手术患者患上肢深静脉血栓症 (ULDVT) 的风险比医疗患者更高,来自外围插入的中央导管 (PICC). 标准VTE预防无效,建议在癌症患者中谨慎使用PICC.
科学领域:
- 血管外科 血管外科
- 血栓形成研究研究
- 患者安全 患者安全
背景情况:
- 外围插入的中央导管 (PICC) 对外科住院患者至关重要,但与上肢深静脉血栓症 (ULDVT) 有关.
- 了解手术患者群体中PICC相关的ULDVT的特定风险和预防策略对于降低患者发病率至关重要.
研究的目的:
- 调查住院手术患者中与PICC相关的ULDVT的发生率和危险因素.
- 为了比较手术患者和接受PICCs的医疗患者中ULDVT的发生率.
- 评估标准的药理学静脉血栓栓塞事件 (VTE) 预防在预防PICC-ULDVT时的有效性.
主要方法:
- 对168名接受PICC治疗的外科住院患者和136名接受PICC治疗的医疗住院患者进行了回顾性分析.
- 在外科和医疗队伍之间通过上肢静脉成像确认的ULDVT发病率的比较.
- 从电子健康记录中提取患者人口统计数据,入院详细信息和PICC插入地点.
主要成果:
- 与医疗患者 (1.5%) 相比,手术患者的ULDVT发病率更高 (4.7%),尽管后者年龄和并发症负担更高.
- 在手术患者中,PICC-ULDVT的显著风险因素包括并发癌症,较高的查尔森并发症指数,恶性肠道阻塞和手臂静脉插入.
- 标准的药理学VTE预防并没有显著降低PICC-ULDVT的风险.
结论:
- 住院的外科患者比医疗患者面临与PICC相关的ULDVT的风险更大.
- 在这个队列中,药理性血栓预防在预防PICC-ULDVT方面表现出有限的有效性.
- 在患有癌症,恶性肠道阻塞或高并发症指数的手术患者使用PICC时建议谨慎使用;基底静脉插入可能需要进一步调查.
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