中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2013年
2期
118-121
,共4页
万光明%陈浩芸%汤文英%杨巧琼
萬光明%陳浩蕓%湯文英%楊巧瓊
만광명%진호예%탕문영%양교경
阿司匹林%肺癌患者%PICC%血栓%效果
阿司匹林%肺癌患者%PICC%血栓%效果
아사필림%폐암환자%PICC%혈전%효과
Aspirin%Lung cancer patient%Peripherally inserted central cartheter%Thrombosis%Effect
目的 观察阿司匹林干预对肺癌化疗患者PICC置管后血栓发生的影响.方法 选择2007年12月至2012年6月在上海市胸科医院PICC置管的肺癌患者997例,根据入院时间分为两组,2007年12月至2011年10月为对照组(n=562),2011年11月至2012年6月为研究组(n =435).对照组采用传统置管方法,生理盐水封管.研究组采用改良式置管技术,拜阿司匹林口服,肝素钠稀释液封管.结果 对照组23例患者(4.09％)发生血栓,研究组13例(2.99％).对照组17例在置管后1周内发生血栓,3例在1周至1个月间发生血栓,3例1个月后发生血栓；研究组4例在置管后1周内发生血栓,5例在1周至1个月间发生血栓,4例1个月后发生血栓,两组血栓发生时间差异有统计学意义(Z=-2.221,P=0.026).对照组17例血栓发生在外周浅静脉,6例在锁骨上静脉及颈内静脉；研究组5例在外周浅静脉,8例在锁骨上静脉及颈内静脉,血栓部位的组间差异也有统计学意义(Z=-2.066,P=0.039).结论 预防性口服拜阿司匹林可有效控制肺癌化疗患者PICC置管后血栓发生.
目的 觀察阿司匹林榦預對肺癌化療患者PICC置管後血栓髮生的影響.方法 選擇2007年12月至2012年6月在上海市胸科醫院PICC置管的肺癌患者997例,根據入院時間分為兩組,2007年12月至2011年10月為對照組(n=562),2011年11月至2012年6月為研究組(n =435).對照組採用傳統置管方法,生理鹽水封管.研究組採用改良式置管技術,拜阿司匹林口服,肝素鈉稀釋液封管.結果 對照組23例患者(4.09％)髮生血栓,研究組13例(2.99％).對照組17例在置管後1週內髮生血栓,3例在1週至1箇月間髮生血栓,3例1箇月後髮生血栓；研究組4例在置管後1週內髮生血栓,5例在1週至1箇月間髮生血栓,4例1箇月後髮生血栓,兩組血栓髮生時間差異有統計學意義(Z=-2.221,P=0.026).對照組17例血栓髮生在外週淺靜脈,6例在鎖骨上靜脈及頸內靜脈；研究組5例在外週淺靜脈,8例在鎖骨上靜脈及頸內靜脈,血栓部位的組間差異也有統計學意義(Z=-2.066,P=0.039).結論 預防性口服拜阿司匹林可有效控製肺癌化療患者PICC置管後血栓髮生.
목적 관찰아사필림간예대폐암화료환자PICC치관후혈전발생적영향.방법 선택2007년12월지2012년6월재상해시흉과의원PICC치관적폐암환자997례,근거입원시간분위량조,2007년12월지2011년10월위대조조(n=562),2011년11월지2012년6월위연구조(n =435).대조조채용전통치관방법,생리염수봉관.연구조채용개량식치관기술,배아사필림구복,간소납희석액봉관.결과 대조조23례환자(4.09％)발생혈전,연구조13례(2.99％).대조조17례재치관후1주내발생혈전,3례재1주지1개월간발생혈전,3례1개월후발생혈전；연구조4례재치관후1주내발생혈전,5례재1주지1개월간발생혈전,4례1개월후발생혈전,량조혈전발생시간차이유통계학의의(Z=-2.221,P=0.026).대조조17례혈전발생재외주천정맥,6례재쇄골상정맥급경내정맥；연구조5례재외주천정맥,8례재쇄골상정맥급경내정맥,혈전부위적조간차이야유통계학의의(Z=-2.066,P=0.039).결론 예방성구복배아사필림가유효공제폐암화료환자PICC치관후혈전발생.
Objective To observe the effect of aspirin intervention on thrombosis in lung cancer patients with peripherally inserted central catheter (PICC).Methods From December 2007 to June 2012,a total of 997 cases of lung cancer received PICC insertion in Shanghai Chest Hospital.The patients admitted from December 2007 to October 2011 were in the control group (n =562),while those admitted from November 2011to June 2012 were in the intervention group (n =435).The control group received conventional catheterization and saline tube sealing; the study group was treated with the modified Seldinger technique,oral administration of aspirin enteric tablets,and diluted heparin sodium tube sealing.Results The incidence of thrombosis was4.09％ (23/562) in the control group and 2.99％ (13/435) in the intervention group.In the control group,17 cases of thrombosis occurred within 1 week after catheter insertion,3 between 1 week to 1 month,and 3 after 1 month ; in the intervention group,4 cases of thrombosis occurred within 1 week after catheter insertion,5between 1 week to 1 month,and 4 after 1 month,presenting a significant difference compared with the control group (Z =-2.221,P =0.026).A significant intergroup difference was also observed in terms of thrombus location (Z =-2.066,P =0.039):in the control group,17 cases had thrombus in peripheral superficial vein,and 6 in supraclavicular vein or internal jugular vein; while in the intervention group,5 cases had thrombus in peripheral superficial vein,and 8 in supraclavicular vein or internal jugular vein.Conclusion The prophylactic oral administration of aspirin could effectively reduce the thrombosis in lung cancer patients treated with chemotherapy via PICC.
