A prospective study on the incidence and risk factors of central venous catheter-related thrombosis after gastrointestinal surgery

中国基层医药 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.06.012

Zhenjiang Guo, N. Wang

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Abstract

Objective To investigate the incidence and risk factors of central venous catheter-related thrombosis after gastrointestinal surgery. Methods From May 2018 to May 2019, 124 patients who received surgical treatment with central venous catheter placement in gastrointestinal surgery department at Harrsion International Peace Hospital were prospectively analyzed, and the factors that may be related to catheter-related thrombosis were collected.And performed ultrasound screening before the removal of central venous catheter, According to whether there was thrombosis or not, they were divided into thrombosis group(n=66) and non-thrombosis group(n=58). Multivariate logistic regression analysis was performed for the factors with statistical differences between the two groups. Results A total of 66 patients were diagnosed with catheter-related thrombus by ultrasonography, with an incidence of 53.2%(66/124), 63 cases with no clinical symptoms(50.8%), only 3 cases with clinical symptoms, and the incidence of catheter-related thrombus with symptoms was 2.4%(3/124). The operation type, central venous catheter indwelling time, fibrinogen on the 3rd day after surgery and D-dimer on the 3rd day after surgery between the two groups had statistically significant differences (χ2=21.415, 7.651, t=5.7181, 0.418, all P<0.05). Multivariable logistic regression analysis showed that operation type(OR=0.157, 95%CI: 0.040-0.612, P=0.008), fibrinogen on the 3rd day after surgery(OR=7.371, 95%CI: 2.318-23.442, P=0.001), D-dimer on the 3rd day after surgery(OR=6.920, 95%CI: 2.854-16.783, P=0.000) were independent risk factors of catheter-related thrombosis. Conclusion The incidence of central venous catheter-related thrombosis is higher after gastrointestinal surgery, and most patients have no obvious clinical symptoms.The patients who undergoing tumor surgery or with abnormal levels of fibrinogen and D-dimer on the 3rd day after surgery should aware of catheter-related thrombosis. Key words: Gastrointestinal diseases; Surgery; Central venous catheters; Venous thrombosis; Risk factor; Neoplasms; Fibrinogen; Fibrin fragment D

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胃肠道手术后中心静脉导管相关血栓形成发生率及危险因素的前瞻性研究

目的探讨胃肠手术后中心静脉导管相关血栓形成的发生率及危险因素。方法对2018年5月至2019年5月在哈里森国际和平医院胃肠外科接受中心静脉置管手术治疗的124例患者进行前瞻性分析，收集可能与置管相关血栓形成相关的因素。并在拔除中心静脉导管前进行超声筛查，根据是否有血栓形成分为血栓形成组(n=66)和非血栓形成组(n=58)。对两组差异有统计学意义的因素进行多因素logistic回归分析。结果超声诊断导管相关性血栓66例，发生率为53.2%(66/124)，无临床症状63例(50.8%)，有临床症状仅3例，有症状的导管相关性血栓发生率为2.4%(3/124)。两组患者手术方式、中心静脉置管时间、术后第3天纤维蛋白原水平、术后第3天d -二聚体水平差异均有统计学意义(χ2=21.415、7.651,t=5.7181、0.418,P均<0.05)。多变量logistic回归分析显示，手术类型(OR=0.157, 95%CI: 0.040 ~ 0.612, P=0.008)、术后第3天纤维蛋白原(OR=7.371, 95%CI: 2.318 ~ 23.442, P=0.001)、术后第3天d -二聚体(OR=6.920, 95%CI: 2.854 ~ 16.783, P=0.000)是导管相关血栓形成的独立危险因素。结论胃肠道手术后中心静脉置管相关血栓的发生率较高，且多数患者无明显临床症状。接受肿瘤手术或术后第3天纤维蛋白原、d -二聚体水平异常的患者应注意导管相关血栓形成。关键词:胃肠道疾病;手术;中心静脉导管;静脉血栓形成;风险因素;肿瘤;纤维蛋白原;纤维蛋白片段D

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.