股静脉置管术后血栓形成的原因分析.docVIP

精品论文 参考文献 股静脉置管术后血栓形成的原因分析 罗　洁 　　成都市第一人民医院肾内科　四川　成都　６１００４１ 　　【摘要】　目的　探讨血液透析患者股脉置管术后血栓形成的相关因素,并提出护理策略.方法　研究对象是随机抽取我院２０１２年５月至２０１４年４月收治的２０８例血液透析患者,行股静脉置管术后４周观察超声诊断结果,并将其分为血栓组与非血栓组,分析其形成因素并制定护理策略.结果　２０８例行股静脉置管术后,导管周围血栓共９例,占４．３２％,静脉管腔内血栓充填共８例,占３．８４％,静脉管腔壁血栓共８例,占３．８４％,静脉血栓形成伴狭窄共７例,占３．３６％,股静脉血栓形成共３２例,占１５．３８％,股静脉血栓未形成占１７６例;３２例术后静脉血栓形成的患者中,主要因素为导管留置时间长因素共１１例,占３４．３８％,血清胆固醇高共１０例,占３１．２５％,共５例,血浆白蛋白低占１５．６３％,导管感染共４例,占１２．５％,无肝素或肝素减量透析者２例,占６．２４％,以上因素与对照组比较均有统计学差异(P＜０．０５).结论　血液透析患者股静脉置管术后血栓形成概率较高,其中导致术后血栓形成的因素有管留置时间长、血清胆固醇高、低蛋白血症、导管感染、无肝素后肝素减量透析等.临床应引起重视,术后积极进行相关护理,结合超声检查,避免血栓形成. 【关键词】　血液透析;　股静脉置管;　血栓;　危险因素;　护理措施;【Abstract】objective:tostudythefemoralveincatheterhemodialysispatientspostoperativethrombosisrelatedfactors,andputforwardthenursingstrategy．Methods:theresearchobjectisrandomlyselectedfrom May２０１２toApril２０１４treated２０８casesofhemodialysispatients,lineoffemoralveincatheterafter４weekstoobservetheultrasonicdiagnosis,anditcanbedividedintothrombosisandthrombosisgroup,analyzestheformingfactorsandnursingstrategy．Results:２０８routinevenipuncturesurgery,catheterthrombosissurroundingatotalof９cases,accountedfor４．３２％,８casesofvenouslumenthrombosisinfilling,accounＧtedfor３．８４％,８casesofvenouslumenatherothrombosis,accountedfor３．８４％,venousthrombosisassociatedwithstenosisinall７cases,accountedfor３．３６％,femoralveinthrombosis,atotalof３２cases,accountedfor１５．３８％,accountedfor１７６casesoffemoralvenousthrombosisdidnotformation;３２casesofpostoperＧativevenousthrombosispatients,themainfactorsforcatheterindwellingtimeislong,atotalof１１cases,accountingfor３４．３８％,serumcholesterollevels,atoＧtalof１０cases(３１．２５％),andatotalof５cases,lowplasmaalbumin(１５．６３％),catheterinfectionin４cases,accountedfor１２．５％,withoutheparinorheparinondialysisin２cases,factorsaccountedformorethan６．２４％,comparedwiththecontrolgroupwerestatisticallysignificant(P＜０．０５)．Conclusion:hemodialysispatientspostoperativefemoralveincatheterthrombosisprobabilityishigher,thecausingfactorsofpostoperativethrombosishavelongtubeindwellingtime,highserumcholesterol,hypoal