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在血性恶性瘤患者中PICC插入的安全性和风险因素:一项回顾性研究

Kun Zhang¹, Hua Huo¹, Xiang-Ling Wu¹

¹Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Peking University, Beijing, 100871, China.

Annals of hematology

|November 7, 2025

概括

需要PICC线路的血液病患者可以安全地接受手术,如果他们有0-1出血风险因素,包括血小板数和凝血状态. 那些具有2个或更多风险因素的人在PICC插入之前需要仔细考虑.

科学领域:

血液学血液学血液学
在瘤学瘤学.
血管接入血管接入

背景情况:

血液学患者经常出现严重的血小板缺血和凝血功能障碍,增加出血风险.
周围插入的中央导管 (PICC) 插入对于管理这些患者的化疗相关不良反应至关重要.
目前的文献缺乏大规模研究和明确的指标来预测PICC插入出血风险在血液瘤学患者低血小板计数或凝血异常.

研究的目的:

评估PICC插入的安全性在血液瘤学患者血小板计数≤50 × 109/L和/或凝血功能障碍.
在这个患者群体中,在PICC插入后24小时内确定出血的独立风险因素.

主要方法:

一项大样本回顾性研究分析了在2017年2月至2020年1月期间接受PICC插入的1511名血液病患者.
患者的血小板计数≤50 × 109/L.
多变量分析确定了在插入后24小时内出血的危险因素.

主要成果:

在PICC插入后24小时内出现出血的独立风险因素是PT≥13秒,血小板数≤25×109/L,ADL得分≤95分.
患者被分为低风险 (0-1因素,1%的出血率) 和高风险 (≥2因素,7%的出血率) 两组.
血液制品干预没有显著影响出血率.

结论:

对于血液病患者,PICC插入被认为是安全的,即使血小板数量低,也具有0-1确定的风险因素.
对于具有≥2个风险因子的患者,PICC插入的决定应根据临床症状和患者需求进行个性化.
该研究为风险分层和临床决策提供了有价值的数据,这些数据涉及PICC在高风险血液瘤学患者的安置.

关键词:

流血出血流血出血凝血功能障碍凝血功能障碍血液的恶性瘤.标签:PICC 标签:PICC 标签:PICC 血小板减少症 (Thrombocytopenia) 是一个严重的疾病.

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