【摘要】 目的探索双下肢抬高联合间歇性充气加压装置(IPC)在预防肺癌患者股静脉留置外周导入中心静脉导管(PICC)下肢深静脉血栓(DVT)形成的效果。方法采用回顾性病例对照研究方法,收集2016年10月至2018年12月在该院行股静脉PICC留置的符合纳入标准的肺癌患者140例,按照术中预防血栓方法分组:A组为双下肢抬高联合IPC组,B组为双下肢抬高组,C组为双下肢IPC组,D组为对照组(不使用下肢抬高及IPC措施),各35例。观察各组导管相关并发症(导管感染、导管阻塞及导管脱出),并使用多普勒彩色超声仪动态观察4组患者置管前及置管后1、3、5、10、15、22、30d腹股沟股静脉平均血流速度、最大血流速度和下肢DVT发生率。结果 A、B、C、D组患者导管感染(2.9%、0,2.9%、2.9%)、导管阻塞(5.7%、5.7%、5.7%、2.9%)、导管脱出(8.6%、2.9%、5.7%、5.7%)及总导管相关并发症(17.2%、8.6%、14.3%、11.4%)发生率比较,差异均无统计学意义(P>0.05)。置管后1、3、5、10、15d,4组患者最大血流速度比较,差异均无统计学意义(P>0.05)。4组下肢DVT情况:A组发生1例,B组发生3例,C组发生2例,D组发生6例,A组下肢DVT发生率明显低于D组(P=0.034)。结论肺癌患者股静脉PICC留置后采用双下肢抬高联合IPC措施有利于防止下肢血流淤滞,并降低下肢DVT的发生率。更多还原

【Abstract】 Objective To explore the effect of double lower-extremity elevation combined with intermittent pneumatic compression device(IPC)in the prevention of lower-extremity deep venous thrombosis(DVT)in patients with lung cancer after femoral vein indwelling PICC catheter.Methods A retrospective case-control study was conducted,and a total of 140 patients who met the inclusion criteria and received femoral vein PICC catheterization in this hospital from October 2016 to December 2018 were selected.According to intraoperative thrombosis prevention methods,all patients were divided into four groups:group A was the double lower-extremity elevation combined with IPC group,group B was the double lower-extremity elevation group,group C was the double lower-extremity IPC group,and group D was the control group(without lowerextremity elevation and IPC),with 35 cases in each group.The catheter-related complications,including catheter infection,catheter obstruction and catheter prolapse,were observed.The Doppler color ultrasound was used to dynamically observe the the mean blood flow velocity,maximum blood flow velocity and lower-extremity DVT formation rate of the femoral vein before catheterization and 1,3,5,10,15,22 dafter catheterization.Results No statistically significant difference was found in the catheter infection(2.9%,0,2.9%,2.9%),catheter obstruction(5.7%,5.7%,5.7%,2.9%),catheter prolapse(8.6%,2.9%,5.7%,5.7%)and common catheter-related complications(17.2%,8.6%,14.3%,11.4%)among group A,B,C and D(P>0.05).At 1,3,5,10,and 15 dafter the catheterization,there was no statistically significant difference in the maximum blood flow velocity among the four groups(P>0.05).The incidence of lower-extremity DVT was as followed:1 case occurred in group A,3 cases occurred in group B,2 cases occurred in group C and 6 cases occurred in group D.The incidence of lower-extremity DVT in group A was significantly lower than that in group D(P=0.034).Conclusion After the femoral vein indwelling PICC catheter in patients with lung cancer,the nursing measures of double lower-extremity elevation combined with IPC is beneficial to prevent lower-extremity blood flow stagnation and reducing the incidence of lower-extremity DVT.更多还原