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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (7): 63-67.doi: 10.6040/j.issn.1671-7554.0.2020.1717

• • 上一篇    

定期超声检查在中心静脉置入设备相关深静脉血栓诊治中的应用价值

王宁1,郭振江2,张媛媛3,王晶1,郭伟1,王金荣1,崔朝勃1   

  • 发布日期:2021-07-16
  • 通讯作者: 崔朝勃. E-mail:zhaobocui2014@163.com
  • 基金资助:
    河北省医学科学研究课题计划(20191768)

Value of regular ultrasound examination in the diagnosis and treatment of deep venous thrombosis associated with central venous access device

WANG Ning1, GUO Zhenjiang2, ZHANG Yuanyuan3, WANG Jing1, GUO Wei1, WANG Jinrong1, CUI Zhaobo1   

  1. 1. Department of Respiration;
    2. Department of General Surgery;
    3. Department of Pharmacy, Harrsion International Peace Hospital, Hengshui 053000, Hebei, China
  • Published:2021-07-16

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摘要： 目的 探讨定期超声检查在中心静脉置入设备相关深静脉血栓诊治中的应用价值。 方法 选取2018年5月至2019年9月于哈励逊国际和平医院应用中心静脉置入设备(CVAD)肿瘤患者440例,按随机数字表法分为观察组(n=221)和对照组(n=219)。观察组每隔3周超声检查记录是否出现中心静脉置入设备相关深静脉血栓(CRDVT),对照组则在出现临床症状后行超声检查诊断是否存在CRDVT,对两组确诊的CRDVT患者,进行不少于90 d的超声评估直至CVAD去除,记录治疗过程中是否存在血栓复发。比较两组间CRDVT诊断率、非计划CVAD去除率、血栓复发率以及血栓后综合征(PTS)发生率。 结果 两组基本资料差异均无统计学意义(P>0.05)。观察组CRDVT诊断率为9.5%(21例),对照组CRDVT诊断率为4.6%(10例),两组间CRDVT诊断率差异有统计学意义(χ2=4.092,P=0.043);观察组CVAD非计划去除率为0.9%(2例),对照组CVAD非计划去除率为4.1%(9例),两组CVAD非计划去除率差异有统计学意义(χ2=4.634,P=0.031);观察组和对照组CRDVT患者90d的累积血栓复发率分别为15.3%和10.0%,两组累积血栓复发率差异无统计学意义(Logrank=0.003,P=0.953);观察组和对照组CRDVT患者血栓后综合征发生率分别为4.7%和40%,两组间PTS发生率差异有统计学意义(χ2=3.886,P=0.049)。 结论 定期超声检查可以提高CRDVT的诊断率,减少非计划CVAD去除率及PTS发生率。

关键词: 静脉置入设备, 静脉导管, 上肢深静脉血栓, 静脉血栓栓塞症, 肿瘤

Abstract: Objective To evaluate the value of regular ultrasound examination in the diagnosis and treatment of deep vein thrombosis associated with central venous access device(CVAD). Methods A total of 440 cancer patients with CAVD treated in Harrsion International Peace Hospital during May 2018 and Sep. 2019 were randomly divided into the observation group(n=221)and observation group(n=219). The observation group received ultrasound examination every 3 weeks to detect the presence of CVAD-related deep venous thrombosis(CRDVT), while the control group received ultrasound examination when clinical symptoms appeared. The patients with CRDVT diagnosed in the two groups were evaluated with ultrasound for no less than 90 days until CVAD was removed, and the thrombosis recurrence during this period was recorded. The diagnostic rate of CRDVT, rate of unplanned CVAD removal, rate of thrombosis recurrence and incidence of post thrombotic syndrome(PTS)were compared between the two groups. Results There was no significant difference in the basic data between the two groups(P>0.05). The diagnostic rate of CRDVT was 9.5%(21 cases)in the observation group and 4.6%(10 cases)in the control group(χ2=4.092, P=0.043). The rate of unplanned CVAD removal was 0.9%(2 cases)in the observation group and 4.1%(9 cases)in the control group(χ2=4.634, P=0.031). The cumulative thrombosis recurrence rate of CRDVT patients in 90 days was 15.3% in the observation group and 10.0% in the control group(Logrank=0.003, P=0.953). The incidence of PTS was 4.7% in the observation group and 40% in the control group(χ2=3.886, P=0.049). Conclusion Regular ultrasonic examination can improve the diagnostic rate of CRDVT and reduce the rate of unplanned CVAD removal and PTS incidence.

Key words: Vascular access devices, Catheters, Upper extremity deep vein thrombosis, Venous thrombosis, Neoplasms

中图分类号: 

  • R574
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