老年患者应用PICC管形成静脉血栓的诱因及其预防措施.docVIP

精品论文 参考文献 老年患者应用PICC管形成静脉血栓的诱因及其预防措施 湖南省长沙市中心医院 湖南长沙 410004 【摘 要】目的 探讨老年患者应用PICC管出现静脉血栓形成的诱因及其预防措施。方法 取2011年6月至2014年6月于我院血液肿瘤科行PICC治疗的患者166例，其中发生静脉血栓的共有10例。以回顾性的方法进行患者临床资料分析，探究出现静脉血栓形成的原因并以此制定防护策略。结果 导致10例老年患者在应用PICC管出现静脉血栓形成的原因有：年龄因素、原发疾病、导管本身问题、血管内皮损、血液黏稠度高、置管肢体活动少、没有主动或坚持做握拳运动等。10例患者7例予以低分子肝素抗凝治疗后好转，3例经低分子肝素抗凝治疗后缓解不明显，予以拔管后以尿激酶共120万单位溶栓治疗后好转。结论 对于置入PICC管后的老年患者保持密切的观察，制定全面的防护策略，减少PICC管出现静脉血栓形成的并发症，从而保障老年患者PICC的临床应用效果，提高患者生活质量。 【关键词】老年患者；PICC管；静脉血栓形成 Abstract：Objective To investigate the cause and prevention of venous thrombosis in elderly patients with PICC tube. Methods from June 2014 to June 2011，166 patients with in our hospital were treated with PICC，and there were 10 cases with venous thrombosis. The clinical data of patients were analyzed retrospectively，and the reasons for the formation of venous thrombosis were analyzed. Results 10 cases of elderly patients in the application of PICC pipe cause venous thrombosis：age，primary disease，catheter itself problems，intravascular lesions，high blood viscosity，catheter less physical activity，not active or insist on doing exercise fist. 7 patients 10 patients with low molecular weight heparin anticoagulation treatment，3 patients with low molecular weight heparin anticoagulation therapy after remission is not obvious，to be drawn after 1 million 200 thousand units of urokinase thrombolysis treatment. Conclusion for the elderly patients after implantation of PICC tube to maintain close observation，develop a comprehensive prevention strategy，reduce the complications of venous thrombosis in PICC tube，so as to protect the clinical application effect of PICC in elderly patients and improve the quality of life of patients. [Key words]：elderly patients；PICC tube；venous thrombosis 近年来，经外周静脉穿刺中心静脉置管（PICC）广泛应用于临床治疗，具有操作简单、安全、留置时间长等特点，尤其有利于大量强刺激性化疗药物或高浓度营养物质的输注，减少对外周静脉的刺激[1]。但是放置PICC管会出现多种并发症，其中以中心静脉导管相关性深静脉血栓形成最为严重，如果没有得到及时有效的治疗可能会出现肺栓塞，严重者可导致死亡。老年患者置入PICC管后出现深静脉血栓的发生率高达4．5％[2]。为了探