老年患者PICC导管相关性上肢深静脉血栓治疗的影响因素

目的：研究老年患者PICC相关上肢深静脉血栓的治疗效果及影响因素。方法：选择我院西院233例行PICC置管后发生上肢深静脉血栓的老年患者，将其分为再通组及未再通组，收集患者的一般资料、基础疾病史、置管相关信息、血栓相关数据、是否拔除导管以及是否抗栓治疗等数据，并对结果进行统计分析。结果：126例上肢深静脉血栓患者中再通组拔除导管和接受抗栓治疗的比例明显高于不通组；拔除导管和接受抗栓治疗的患者其血栓完全再通的比例高于对照组。发现血栓后拔除导管组以及接受抗栓治疗组，其累积不通率要明显低于对照组。结论：PICC导管相关上肢深静脉血栓治疗中，拔除导管和接受抗栓治疗者其效果更优；出现PICC管相关性血栓的时候，对于导管仍有用途，没有感染迹象的老年患者，主张保留置管。

An analysis of the factors affecting the treatment of peripheral inserted central catheter associated upper extremity deep vein thrombosis in elderly patients

Objective: To determine the treatment effectiveness and affecting factors for peripherally inserted central catheter (PICC) associated upper extremity deep vein thrombosis (UEDVT) in elderly patients. Methods: Two hundred of thirty-three patients diagnosed as PICC catheter-related upper extremity deep venous thrombosis in our hospital was enrolled in this study. The patients were divided into two groups depending on whether a thrombus recanalization was achieved or not. Data of patients, including general information, past history of diseases, catheter-related information, thrombosis-related information, whether remove the catheter and antithrombotic treatment were recorded and analyzed. Results: Among all the 126 patients with upper extremity deep vein thrombosis, the ratio of patients receiving catheter removal and antithrombotic treatment to those without these treatments was obviously higher in the group where a thrombus recanalization was achieved, compared with the group where a thrombus recanalization wasn't achieved. A higher fraction of patients underwent complete recanalization by catheter removal and antithrombotic treatment compared with the reference group. Conclusion: For patients with PICC-related upper extremity deep vein thrombosis, catheter removal and antithrombotic treatment were found to be more effective. For elderly patients diagnosed with PICC-related thrombosis, we suggest to keep the PICC for further treatment, as long as no infection occurs.