血液肿瘤患者PICC导管相关性血栓发生原因与预防研究进展
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摘要
目前,经外周静脉置入中心静脉导管(Peripherally Inserted Central Catheter,PICC)在血液肿瘤患者中应用较为普及,PICC导管相关性血栓是这类群体最常见且最严重的并发症之一,文章阐述血液肿瘤患者PICC相关性血栓的危险因素及预防策略,为降低其发生率提供参考依据。
PICC is widely used among patients with hematologic malignancies. However PICC-related thrombosis is one of the most common and serious complications. In this study, the risk factors and prevention strategies of PICC catheter related thrombosis related thrombosis were investigated among patients with hematological malignancies. It is expected to provide a reference for reducing the incidence of PICC catheter related thrombosis.
PICC is widely used among patients with hematologic malignancies. However PICC-related thrombosis is one of the most common and serious complications. In this study, the risk factors and prevention strategies of PICC catheter related thrombosis related thrombosis were investigated among patients with hematological malignancies. It is expected to provide a reference for reducing the incidence of PICC catheter related thrombosis.
引文
[1]Curtogarcía N,Garcíasuárez J,Callejas CM,et al.A team-based multidisciplinary approach to managing peripherally inserted central catheter complications in high-risk haematological patients:a prospective study.Supportive Care in Cancer,2016,24(1):93-101.
[2]Yao P,He X,Zhang R,et al.The influence of MTHFR genetic polymorphisms on adverse reactions after methotrexate in patients with hematological malignancies:a meta-analysis.Hematology,2018:1.
[3]顾磊,章亮,周晖,等.血液肿瘤患者PICC置管后并发症的发生风险及预防对策.医院管理论坛,2017,34(9):17-19.Gu L,Zhang L,Zhou H,et al.Risk and prevention of complications among patients with hematologic malignancies after PICC catheterization.Hospital Management Forum,2017,34(9):17-19.
[4]Htun KT,Ma M,Ayy L.Incide nce andoutcomes of catheter related thrombosis(CRT)in patients with acute leukemia using a plateletadjusted lowmolecular weight heparin regimen.JThromb Thrombolys,2018:1-7.
[5]Levi M.Clinical characteristics of disseminated intravascular coagulation in patients with solid and hematological cancers.Thromb Res,2018,14(6):77-81.
[6]Sallah S,Wan JY,Nguyen NP,et al.Disseminated intravascular coagulation in solid tumors:clinical and pathologic study.Thrombosis&Haemostasis,2001,86(3):828-833.
[7]Barbui T,Falanga A.Disseminated intravascular coagulation in acute leukemia,Semin Thromb Hemost,1988,14(4):339-350.
[8]Colombo R,Gallipoli P,Castelli R.Thrombosis and hemostatic abnormalities in hematological malignancies.Clin Lymphoma Myeloma Leuk,2014,14(6):441-450.
[9]Evans NS,Ratchford EV.Catheter-related venous thrombosis.Vasc Med,2018,23(4):1-3.
[10]徐波,耿翠芝.肿瘤治疗血管通道安全指南.北京:中国协和医科大学出版社,2015.Xu B,Geng CZ.Safety guidelines for vascular access in cancer treatment.Beijing:Chinese Peking Union Medical College Press,2015.
[11]梁仁瑞,梁爱萍,吴丽,等.血液肿瘤患者PICC意外拔管原因分析及对策.护理学报,2009,16(14):37-38.Liang RR,Liang AP,Wu L,et al.Cause analysis and countermeasures of accidental extubation of PICC in patients with hematological malignancies.Journal of Nursing(China),2009,16(14):37-38.
[12]Sriskandarajah P,Webb K,Chisholm D,et al.Retrospective cohort analysis comparing theincidence of deep vein thromboses betweenperipherally-inserted and long-term skin tunneledvenous catheters in hemato-oncology patients.Thrombosis Journa,2015,13(1):21.
[13]刘艳慧,张茵,翟亚平,等.血液肿瘤患者PICC相关性静脉血栓临床分析.血栓与止血学,2016,22(4):433-435.Liu YH,Zhang Y,Zhai YP,et al.Clinical features of venous thrombosis associated with peripherally inserted central venous catheters in hematological malignancies patients.Chinese Journal of Thrombosis and Hemostasis,2016,22(4):433-435.
[14]王琳.血液肿瘤患者PICC置管后如何预防和减少静脉血栓的发生.中国社区医师,2016,32(26):164-166.Wang L.How to prevent and reduce the occurrence of venous thrombosis after PICCcatheter insertion in patients with hematologic malignancies.Chinese Community Doctors,2016,32(26):164-166.
[15]Cortelezzi A,Moia M,Falanga A,et al.Incidence of thrombotic complications in patients with haematological malignancies with central venous catheters:a prospective multicentre study.Br J Haematol,2005,129(6):811-817.
[16]Chopra V,Anand S,Hickner A,et al.Risk of venous thromboembolism associated with peripherally inserted central catheters:a systematic review and meta-analysis.Lancet,2013,382(9889):311-325.
[17]杨弘,聂波.66例恶性血液肿瘤患者深静脉血栓原因与防治.中国医药指南,2013,11(6):154-155.Yang H,Nie B.Causes and prevention of deep venous thrombosis in 66 patients with malignant hematological malignancies Chinese Medicine Guide,2013,11(6):154-155.
[18]Falanga A,Marchetti M.Venous thromboembolism in the hematologic malignancies.J Clin Oncol,2009,24(6):4848-4857.
[19]易小青,付爱明,张兰,等.规范化护理流程在预防PICC导管堵塞中的应用.现代临床护理,2013,12(4):25-28.Yi XQ,Fu A M,Zhang L,et al.Role of standardized nursing procedures in the prevention of peripherally inserted central blockage catheter.Modern Clinical Nursing,2013,12(4):25-28.
[20]McAulif fe E,O'Shea S,K ha n M J.Retrospective audit of the Peripherally Inserted Central Catheter(PICC)associated thrombosis in patients with haematological malignancies at Cork University Hospital.Thrombosis Research,2016,140(1):176.
[21]芦璐,姚艳粉,宗俊学.血栓前状态与原发性高血压关系的临床研究.中国综合临床,2006,22(2):97-100.Lu L,Yao YF,Zong JX.Clinical study on relationship between prethrombotic state and essential hypertension.Chinese Medicine of China,2006,22(2):97-100.
[22]Wilson,James D,Guardiola,et al.Does hyperglycemia affect risk of peripherally inserted central catheter-related upper extremity venous thrombosis.J Infu Nur,2018,41(3):176-179.
[23]Pomero F,Di MM,Fenoglio L,et al.Is diabetes a hypercoagulable state:a critical appraisal.Acta Diabetologica,2015,52(6):1007-1016.
[24]Bennett CL,Silver SM,Djulbegovic B,et al.Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia.JAMA J Am Med Assoc,2008,299(8):914-924.
[25]Del Principe MI,Buccisano F,Maurillo L,et al.Infections increase the risk of central venous catheter-related thrombosis in adult acute myeloid leukemia.Thrombosis Research,2013,132(5):511-514.
[26]Pan L,Zhao Q,Yang X.Risk factors for venous thrombosis associated with peripherally inserted central venous catheters.Intl J ClinExp Med,2014,7(12):5814-5819.
[27]Tran HA,Arellano M,Chamsuddin A,et al.Deep venous thromboses in patients with hematological malignancies after peripherally inser ted cent ral venous catheters.Leu k Lymphoma,2010,51(8):1473-1477.
[28]Wilson TJ,Brown DL,Meurer WJ,et al.Risk factors associated with peripherally inserted central venous catheter-related large vein thrombosis in neurological intensive care patients.Intensive Care Med,2012,38(2):272-278.
[29]Liem TK,Yanit KE,Moseley SE,et al.Peripherally inserted central catheter usage patterns and associated symptomatic upper extremity venous thrombosis.J Vasc Surg,2012,55(3):761-767.
[30]McAulif fe E,O'Shea S,K ha n M J.Retrospective audit of the Peripherally Inserted Central Catheter(PICC)associated thrombosis in patients with haematological malignancies at Cork University Hospital.Thrombosis Research,2016,140(1):176.
[31]Sharp R,Cummings M,Fielder A,et al.The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter(PICC):a prospective cohort study.Int J Nurs Stud,2015,52(3):677-685.
[32]邱群,钱火红,李海燕,等.经外周静脉置入中心静脉导管相关性血栓形成的原因分析及护理.护士进修杂,2016,31(11):1047-1048.Qiu Q,Qian HH,Li HY,et al.Analysis and nursing of peripherally inserted central venous catheter related thrombosis.Journal of Nursing Training,2016,31(11):1047-1048.
[33]Morano SG,Latagliata R,Girmenia C,et al.Catheter-associated bloodstream infections and thrombotic riskin hematologic patients with peripherally inserted centralcatheters(PICC).Support Care Cancer,2015,23(11):3289-3296.
[34]张伟伟,方云.血液肿瘤患者PICC导管相关性血栓形成的危险因素分析.临床血液学杂志,2018,31(3):197-200.Zhang WW,Fang Y.Estimation of risk factors for PICC catheter related thrombosis in patients with hematological malignancies.Journal of Clinical Hematology,2018,31(3):197-200.
[35]闫岩,耿传营,田颖.急性白血病患者PICC血栓形成的相关影响因素分析.中国地方病防治杂志,2017,32(12):1422-1423.Yan Y,Geng CY,Tian Y.Analysis of related factors of PICC thrombosis in patients with acute leukemia.Chinese Journal of Control of Endemic Disenaces,2017,32(12):1422-1423.
[36]Hao N,Xie X,Zhou Z,et al.Nomogram predicted risk of peripherally inserted central catheter related thrombosis.Sci Rep,2017,7(1):6344.
[37]贺连香,张京慧,高红梅.静脉治疗护理操作技术与管理.长沙:中南大学出版社,2014:259.He LX,Zhang JH,Gao HM.Technology and management of nursing care in intravenous therapy.Changsha:Central South University Press,2014:259.
[38]Lyman GH,Khorana AA,Falanga A,et al.American Society of Clinical Oncology guideline:recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer.J Clin Oncol,2007,25(34):5490-5505.
[39]Stock W,Douer D,Deangelo DJ,et al.Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents:recommendations of an expert panel.Leuk Lymphoma,2011,52(12):2237-2253.
[40]Liu Y,Gao Y,Wei L,et al.Peripherally inserted central catheter thrombosis incidence and risk factors in cancer patients:a double-center prospective investigation.Ther Clin Risk Manag,2015,11(default):153.
[41]陶丽,吴卫琴,杨娅娟,等.健康教育路径对血液肿瘤患者PICC置管后并发症的干预研究.临床护理杂志,2013,12(6):14-16.Tao L,Wu WQ,Yang YJ.et al.Evaluation on effect of health education clinical path in preventing complications among patients with hematological malignancies after PICCplacement.Journal of Clinical Nursing,2013,12(6):14-16.
[42]叶玲荣,徐勤容,余丽娟,等.PICC在血液肿瘤患者中的应用及常见并发症对策.中国现代医生,2011,49(26):110-111.Ye LR,Xu QR,Yu LJ,et al.Application of PICCin patients with hematological malignancies and the countermeasures to common complication.China Modern Doctors,2011,49(26):110-111.
[43]Akl EA,Kamath G,Yosuico V,et al.Thromboprophylaxis for patients with cancer and central venous catheters:a systematic review and a meta-analysis.Cancer,2008,112(11):2483-2492.
[44]Abdelkefi A,Ben OT,Kammoun L,et al.Prevention of central venous line-related thrombosis by continuous infusion of low-dose unfractionated heparin,in patients with haematooncological disease:a randomized controlled trial.Thrombosis&Haemostasis,2004,92(3):654-661.
[2]Yao P,He X,Zhang R,et al.The influence of MTHFR genetic polymorphisms on adverse reactions after methotrexate in patients with hematological malignancies:a meta-analysis.Hematology,2018:1.
[3]顾磊,章亮,周晖,等.血液肿瘤患者PICC置管后并发症的发生风险及预防对策.医院管理论坛,2017,34(9):17-19.Gu L,Zhang L,Zhou H,et al.Risk and prevention of complications among patients with hematologic malignancies after PICC catheterization.Hospital Management Forum,2017,34(9):17-19.
[4]Htun KT,Ma M,Ayy L.Incide nce andoutcomes of catheter related thrombosis(CRT)in patients with acute leukemia using a plateletadjusted lowmolecular weight heparin regimen.JThromb Thrombolys,2018:1-7.
[5]Levi M.Clinical characteristics of disseminated intravascular coagulation in patients with solid and hematological cancers.Thromb Res,2018,14(6):77-81.
[6]Sallah S,Wan JY,Nguyen NP,et al.Disseminated intravascular coagulation in solid tumors:clinical and pathologic study.Thrombosis&Haemostasis,2001,86(3):828-833.
[7]Barbui T,Falanga A.Disseminated intravascular coagulation in acute leukemia,Semin Thromb Hemost,1988,14(4):339-350.
[8]Colombo R,Gallipoli P,Castelli R.Thrombosis and hemostatic abnormalities in hematological malignancies.Clin Lymphoma Myeloma Leuk,2014,14(6):441-450.
[9]Evans NS,Ratchford EV.Catheter-related venous thrombosis.Vasc Med,2018,23(4):1-3.
[10]徐波,耿翠芝.肿瘤治疗血管通道安全指南.北京:中国协和医科大学出版社,2015.Xu B,Geng CZ.Safety guidelines for vascular access in cancer treatment.Beijing:Chinese Peking Union Medical College Press,2015.
[11]梁仁瑞,梁爱萍,吴丽,等.血液肿瘤患者PICC意外拔管原因分析及对策.护理学报,2009,16(14):37-38.Liang RR,Liang AP,Wu L,et al.Cause analysis and countermeasures of accidental extubation of PICC in patients with hematological malignancies.Journal of Nursing(China),2009,16(14):37-38.
[12]Sriskandarajah P,Webb K,Chisholm D,et al.Retrospective cohort analysis comparing theincidence of deep vein thromboses betweenperipherally-inserted and long-term skin tunneledvenous catheters in hemato-oncology patients.Thrombosis Journa,2015,13(1):21.
[13]刘艳慧,张茵,翟亚平,等.血液肿瘤患者PICC相关性静脉血栓临床分析.血栓与止血学,2016,22(4):433-435.Liu YH,Zhang Y,Zhai YP,et al.Clinical features of venous thrombosis associated with peripherally inserted central venous catheters in hematological malignancies patients.Chinese Journal of Thrombosis and Hemostasis,2016,22(4):433-435.
[14]王琳.血液肿瘤患者PICC置管后如何预防和减少静脉血栓的发生.中国社区医师,2016,32(26):164-166.Wang L.How to prevent and reduce the occurrence of venous thrombosis after PICCcatheter insertion in patients with hematologic malignancies.Chinese Community Doctors,2016,32(26):164-166.
[15]Cortelezzi A,Moia M,Falanga A,et al.Incidence of thrombotic complications in patients with haematological malignancies with central venous catheters:a prospective multicentre study.Br J Haematol,2005,129(6):811-817.
[16]Chopra V,Anand S,Hickner A,et al.Risk of venous thromboembolism associated with peripherally inserted central catheters:a systematic review and meta-analysis.Lancet,2013,382(9889):311-325.
[17]杨弘,聂波.66例恶性血液肿瘤患者深静脉血栓原因与防治.中国医药指南,2013,11(6):154-155.Yang H,Nie B.Causes and prevention of deep venous thrombosis in 66 patients with malignant hematological malignancies Chinese Medicine Guide,2013,11(6):154-155.
[18]Falanga A,Marchetti M.Venous thromboembolism in the hematologic malignancies.J Clin Oncol,2009,24(6):4848-4857.
[19]易小青,付爱明,张兰,等.规范化护理流程在预防PICC导管堵塞中的应用.现代临床护理,2013,12(4):25-28.Yi XQ,Fu A M,Zhang L,et al.Role of standardized nursing procedures in the prevention of peripherally inserted central blockage catheter.Modern Clinical Nursing,2013,12(4):25-28.
[20]McAulif fe E,O'Shea S,K ha n M J.Retrospective audit of the Peripherally Inserted Central Catheter(PICC)associated thrombosis in patients with haematological malignancies at Cork University Hospital.Thrombosis Research,2016,140(1):176.
[21]芦璐,姚艳粉,宗俊学.血栓前状态与原发性高血压关系的临床研究.中国综合临床,2006,22(2):97-100.Lu L,Yao YF,Zong JX.Clinical study on relationship between prethrombotic state and essential hypertension.Chinese Medicine of China,2006,22(2):97-100.
[22]Wilson,James D,Guardiola,et al.Does hyperglycemia affect risk of peripherally inserted central catheter-related upper extremity venous thrombosis.J Infu Nur,2018,41(3):176-179.
[23]Pomero F,Di MM,Fenoglio L,et al.Is diabetes a hypercoagulable state:a critical appraisal.Acta Diabetologica,2015,52(6):1007-1016.
[24]Bennett CL,Silver SM,Djulbegovic B,et al.Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia.JAMA J Am Med Assoc,2008,299(8):914-924.
[25]Del Principe MI,Buccisano F,Maurillo L,et al.Infections increase the risk of central venous catheter-related thrombosis in adult acute myeloid leukemia.Thrombosis Research,2013,132(5):511-514.
[26]Pan L,Zhao Q,Yang X.Risk factors for venous thrombosis associated with peripherally inserted central venous catheters.Intl J ClinExp Med,2014,7(12):5814-5819.
[27]Tran HA,Arellano M,Chamsuddin A,et al.Deep venous thromboses in patients with hematological malignancies after peripherally inser ted cent ral venous catheters.Leu k Lymphoma,2010,51(8):1473-1477.
[28]Wilson TJ,Brown DL,Meurer WJ,et al.Risk factors associated with peripherally inserted central venous catheter-related large vein thrombosis in neurological intensive care patients.Intensive Care Med,2012,38(2):272-278.
[29]Liem TK,Yanit KE,Moseley SE,et al.Peripherally inserted central catheter usage patterns and associated symptomatic upper extremity venous thrombosis.J Vasc Surg,2012,55(3):761-767.
[30]McAulif fe E,O'Shea S,K ha n M J.Retrospective audit of the Peripherally Inserted Central Catheter(PICC)associated thrombosis in patients with haematological malignancies at Cork University Hospital.Thrombosis Research,2016,140(1):176.
[31]Sharp R,Cummings M,Fielder A,et al.The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter(PICC):a prospective cohort study.Int J Nurs Stud,2015,52(3):677-685.
[32]邱群,钱火红,李海燕,等.经外周静脉置入中心静脉导管相关性血栓形成的原因分析及护理.护士进修杂,2016,31(11):1047-1048.Qiu Q,Qian HH,Li HY,et al.Analysis and nursing of peripherally inserted central venous catheter related thrombosis.Journal of Nursing Training,2016,31(11):1047-1048.
[33]Morano SG,Latagliata R,Girmenia C,et al.Catheter-associated bloodstream infections and thrombotic riskin hematologic patients with peripherally inserted centralcatheters(PICC).Support Care Cancer,2015,23(11):3289-3296.
[34]张伟伟,方云.血液肿瘤患者PICC导管相关性血栓形成的危险因素分析.临床血液学杂志,2018,31(3):197-200.Zhang WW,Fang Y.Estimation of risk factors for PICC catheter related thrombosis in patients with hematological malignancies.Journal of Clinical Hematology,2018,31(3):197-200.
[35]闫岩,耿传营,田颖.急性白血病患者PICC血栓形成的相关影响因素分析.中国地方病防治杂志,2017,32(12):1422-1423.Yan Y,Geng CY,Tian Y.Analysis of related factors of PICC thrombosis in patients with acute leukemia.Chinese Journal of Control of Endemic Disenaces,2017,32(12):1422-1423.
[36]Hao N,Xie X,Zhou Z,et al.Nomogram predicted risk of peripherally inserted central catheter related thrombosis.Sci Rep,2017,7(1):6344.
[37]贺连香,张京慧,高红梅.静脉治疗护理操作技术与管理.长沙:中南大学出版社,2014:259.He LX,Zhang JH,Gao HM.Technology and management of nursing care in intravenous therapy.Changsha:Central South University Press,2014:259.
[38]Lyman GH,Khorana AA,Falanga A,et al.American Society of Clinical Oncology guideline:recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer.J Clin Oncol,2007,25(34):5490-5505.
[39]Stock W,Douer D,Deangelo DJ,et al.Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents:recommendations of an expert panel.Leuk Lymphoma,2011,52(12):2237-2253.
[40]Liu Y,Gao Y,Wei L,et al.Peripherally inserted central catheter thrombosis incidence and risk factors in cancer patients:a double-center prospective investigation.Ther Clin Risk Manag,2015,11(default):153.
[41]陶丽,吴卫琴,杨娅娟,等.健康教育路径对血液肿瘤患者PICC置管后并发症的干预研究.临床护理杂志,2013,12(6):14-16.Tao L,Wu WQ,Yang YJ.et al.Evaluation on effect of health education clinical path in preventing complications among patients with hematological malignancies after PICCplacement.Journal of Clinical Nursing,2013,12(6):14-16.
[42]叶玲荣,徐勤容,余丽娟,等.PICC在血液肿瘤患者中的应用及常见并发症对策.中国现代医生,2011,49(26):110-111.Ye LR,Xu QR,Yu LJ,et al.Application of PICCin patients with hematological malignancies and the countermeasures to common complication.China Modern Doctors,2011,49(26):110-111.
[43]Akl EA,Kamath G,Yosuico V,et al.Thromboprophylaxis for patients with cancer and central venous catheters:a systematic review and a meta-analysis.Cancer,2008,112(11):2483-2492.
[44]Abdelkefi A,Ben OT,Kammoun L,et al.Prevention of central venous line-related thrombosis by continuous infusion of low-dose unfractionated heparin,in patients with haematooncological disease:a randomized controlled trial.Thrombosis&Haemostasis,2004,92(3):654-661.
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