CAJ | 학술논문

目的调查恶性肿瘤患者PICC置管后静脉血栓形成的相关因子水平,建立针对致栓原因的干预模式.方法将恶性肿瘤化疗实施PICC置管后并发静脉血栓的40例患者作为血栓组;选择同期PICC置管后无静脉血栓形成的患者40例作为无血栓组;选择同期门诊健康体检者30例作为健康对照组.对3组分别采血检测凝血系统分子标志物水平、血小板参数及纤溶系统分子标志物水平,并进行比较.结果血栓组患者的vWF、GMPl40、TAT数值均高于健康对照组及无血栓组,而ATⅢ值显著低于健康对照组;血栓组患者MPV和PCT显著高于健康对照组和无血栓组;血栓组患者的PLG、PAI水平均显著高于健康对照组及无血栓组,而PLM值显著低于健康对照组.结论恶性肿瘤化疔患者PICC置管致静脉血栓形成的原因主要由于患者存在明显的高凝状态、血小板活性增强及PICC易导致血栓形成前状态有关.在恶性肿瘤患者PICC置管治疗过程中,应把检测相应凝血系统分子标志物水平、血小板参数、纤溶系统分子标志物水平列为临床工作常规,作为选择早期干预和评价置管效果的一项指标.
목적 조사악성종류환자PICC치관후정맥혈전형성적상관인자수평,건립침대치전원인적간예모식.방법 장악성종류화료실시PICC치관후병발정맥혈전적40례환자작위혈전조;선택동기PICC치관후무정맥혈전형성적환자40례작위무혈전조;선택동기문진건강체검자30례작위건강대조조.대3조분별채혈검측응혈계통분자표지물수평、혈소판삼수급섬용계통분자표지물수평,병진행비교.결과 혈전조환자적vWF、GMPl40、TAT수치균고우건강대조조급무혈전조,이ATⅢ치현저저우건강대조조;혈전조환자MPV화PCT현저고우건강대조조화무혈전조;혈전조환자적PLG、PAI수평균현저고우건강대조조급무혈전조,이PLM치현저저우건강대조조.결론 악성종류화정환자PICC치관치정맥혈전형성적원인주요유우환자존재명현적고응상태、혈소판활성증강급PICC역도치혈전형성전상태유관.재악성종류환자PICC치관치료과정중,응파검측상응응혈계통분자표지물수평、혈소판삼수、섬용계통분자표지물수평렬위림상공작상규,작위선택조기간예화평개치관효과적일항지표.
Objective To investigate the induced-factors levels of venous thrombosis associated with the placement of peripherally inserted central catheters (PICC) in patients with malignant tumor,and establish intervention model accordingly. Methods 40 patients complicated with venous thrombosis after PICC were set as the thrombosis group, 40 patients without venous thrombosis were selected as the no-thrombosis group, 30 healthy cases were selected as the control group. All cases' serum samples were ob-tained to measure the levels of molecular biomarkers of the coagulation system, platelet parameters and molecular biomarkers of the fibrinolysis system. The results of the three groups were assessed. Results Patients in the thrombosis group were reported significantly higher levels of vWF, GMP140,TAT than those in both two other groups, but lower levels of ATⅢ. Higher levels of MPV and PCT were found in the throm-bosis group than those in both two other groups.Tthe data also showed higher PLG and PAI levels and lower levels of PLM in the thrombosis group. Conclusions From this study it shows that patients with malig-nant tumors during the placement of PICC have evident hypercoagnlahility, high- activated platelet and se-vere pre- thrombosis state caused by PICC. In treatment of malignant tumor patients with PICC, the level of coag-ulation system molecular markers, platelet parameters,fibrinolysis molecular markers shoud be used as a clinical routine and as the index of early intervention and evaluation of the PICC.