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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

22卷

期数:

2016年02期

页码:

147-150

栏目:

临床医学

出版日期:

2016-03-20

文章信息/Info

Title:

Analysis of risk factors and establishment of risk model for peripherally inserted central catheter thrombosis

文章编号:

1006-8147（2016）02-0147-04

作者:

蒿若楠¹; 胡 芳¹; 张 杰¹; 马志承²; 唐万斌³; 胡 蒙⁴

(1.天津医科大学总医院普通外科,天津 300052;2.天津第一中心医院普通外科,天津300192;3.天津医科大学公共卫生学院,天津 300070;4.郑州大学第一附属医院老年心血管科,郑州 450052)

Author(s):

HAO Ruo-nan¹; HU Fang¹; ZHANG Jie¹; MA Zhi-cheng²; TANG Wan-bin³; HU Meng⁴

（1.Department of General Surgery, General Hospital, Tianjin Medical University, Tianjin 300052, China；2.Department of General Surgery, Tianjin First Center Hospital, Tianjin 300192,China；3.School of Public Health, Tianjin Medical University, Tianjin 300070, China；4. Department of paediatrics，The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China ）

关键词:

经外周置入中心静脉导管; 上肢深静脉血栓; 危险因素; 预测模型

Keywords:

peripherally inserted central catheter; upper extremity deep venous thrombosis; risk factor; predictive model

分类号:

R6

DOI:

-

文献标志码:

A

摘要:

目的：探索经外周置入中心静脉导管（PICC）相关性上肢深静脉血栓形成的主要危险因素，并建立其风险预测模型。方法：前瞻性研究2014年1月至2015年7月内符合纳入标准的PICC置管患者，根据有无PICC相关性上肢深静脉血栓形成，分为血栓组52例，非血栓组144例。通过单因素分析确定PICC相关性上肢深静脉血栓形成的危险因素。将单因素分析中差异有统计学意义的危险因素进行多元Logistic回归分析，建立风险预测模型。结果：确定中心静脉导管(CVC)/PICC置管史、导管尖端位置、置入血管内径为PICC相关性血栓形成的独立危险因素，据此建立的PICC相关性血栓形成的Logistic回归预测模型为Y=2.040×CVC/PICC置管史＋1.964×导管尖端位置－1.572×置入静脉内径＋3.338。此模型的ROC曲线下面积为0.872，95%CI为0.817-0.927。结论：导管尖端位置、CVC/PICC置管史、血管内径为PICC相关性上肢深静脉血栓形成的独立危险因素，所建立的Logistic回归预测模型能较好地预测PICC相关性上肢深静脉血栓的发生。

Abstract:

Objective ：To investigate the main risk factors of peripherally inserted central catheter(PICC) related upper extremity deep venous thrombosis and （加上to）establish its risk model. Methods：Patients with PICC who were hospitalized between January 2014 and July 2015 were studied and divided into thrombosis group (n=52) patients complicated with venous thrombosis after PICC and non-thrombosis group(n =144) patients without venous thrombosis. By comparing two groups, Statistically different variables were selected to undergo multivariate logistic regression to establish the risk model. Results：Previous CVC(central venous catheter)/PICC insertion, catheter tip position, the diameter of blood vessel were the key factors and logistic regression model was as following: Y=2.040×previous CVC/PICC insertion+1.964×catheter tip position-1.572×diameter of blood vessel+3.338. The area below the receiver operating characteristic curve for the model was 0.872, 95%CI (0.817 to 0.927). Conclusion： Previous CVC/PICC insertion, catheter tip position, and the diameter of blood vessel are the key risk factors for thrombosis. The Logistic regression model based on these factors is reliable in predicting the PICC-related upper extremity deep venous thrombosis.