摘要
目的探讨分级干预措施在非小细胞肺癌(NSCLC)经外周静脉穿刺的中心静脉导管(PICC)置管术后的应用效果。方法收集2019年1月至2021年12月于广安市人民医院接受PICC置管术治疗的128例NSCLC患者的临床资料,将2019年1月至2020年6月采取常规术后置管干预措施的64例患者作为常规组,将2020年7月至2021年12月采取术后分级干预措施的64例患者作为分级组。比较两组患者导管相关性血栓的发生情况,干预前、干预后1个月的置管静脉血流动力学指标(血流峰速度、血流平均速度、血流量)和心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分],以及置管前、下次到院时的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D)、纤维蛋白原(FIB)]水平。比较两组患者置管期间的不良反应发生情况。结果分级组患者导管相关性血栓的发生率、累及穿刺静脉以外静脉的发生率均低于常规组患者,差异均有统计学意义(P<0.05)。干预后,分级组患者置管静脉的血流峰速度、血流平均速度、血流量均高于常规组患者,差异均有统计学意义(P<0.05)。干预后,分级组患者的SAS、SDS评分均低于常规组患者,差异均有统计学意义(P<0.05)。干预后,分级组患者的TT、PT、APTT均长于常规组患者,FIB、D-D水平均低于常规组患者,差异均有统计学意义(P<0.05)。分级组患者的不良反应总发生率低于常规组患者,差异有统计学意义(P<0.05)。结论对于接受PICC置管术治疗的NSCLC患者,分级干预措施可改善患者的血流动力学与凝血功能,有效降低导管相关性血栓的发生风险,提高抗凝治疗的安全性。
Objective To investigate the application effect of graded interventions in patients with non-small cell lung cancer(NSCLC)after peripherally inserted central venous catheter(PICC)catheterization through peripheral venipuncture.Method The clinical data of 128 NSCLC patients who received PICC catheterization in Guang'an People's Hospital from January 2019 to December 2021 were collected.Among them,64 patients who took routine postoperative catheter intervention measures from January 2019 to June 2020 were taken as the routine group,and 64 patients who took postoperative graded interventions from July 2020 to December 2021 were taken as the graded group.The incidence of catheter-related thrombosis in the two groups was compared.The catheterized vein hemodynamic indexes(peak blood flow velocity,average blood flow velocity,blood flow)and psychological status[self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score]were compared between the two groups before the intervention and 1 month after the intervention.The coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer(D-D)level,fibrinogen(FIB)level]were compared between the two groups before the catheter placement and at the next hospital admission.The adverse reactions of the two groups of patients during catheterization were compared.Result The incidence rate of catheter-related thrombosis and the incidence of veins other than the puncture vein in the graded group were lower than those in the routine group,and the differences were statistically significant(P<0.05).After the intervention,the peak blood flow velocity,average blood flow velocity and blood flow of the catheterized vein in the graded group were higher than those in the routine group,and the differences were statistically significant(P<0.05).After the intervention,the SAS and SDS scores of the patients in the graded group were lower than those in the routine group,and the differences were statistically significant(P<0.05).Aft
作者
邓洪渠
曾小梅
王琴
谢大玲
Deng Hongqu;Zeng Xiaomei;Wang Qin;Xie Daling(Department of Oncology,Guang'an People's Hospital,Guang'an 638500,Sichuan,China;Intervention Room,Guang'an People's Hospital,Guang'an 638500,Sichuan,China)
出处
《血管与腔内血管外科杂志》
2022年第7期881-885,共5页
Journal of Vascular and Endovascular Surgery
基金
广安市科技创新项目(2019SYF05)。
