摘要
目的研究自制心电定位系统及利伐沙班对卵巢癌患者经外周置入中心静脉导管(PICC)相关深静脉血栓(DVT)的预防效果。方法选取2016年1月至2019年1月的卵巢癌术后化疗患者172例作为研究对象。将患者按随机数字表法分为观察组87例、对照组85例。其中观察组内又分为PICC术后使用利伐沙班组(44例)和不使用组(43例)。所有患者均留置PICC行多西他塞+卡铂(DC)方案静脉化疗6个周期。观察组采用自制心电定位系统引导PICC尖端定位。其中使用利伐沙班组,留置PICC术后24 h始予口服利伐沙班预防性抗凝治疗3周。对照组采用体表外测量估计导管长度,采用改良塞丁格(Seldinger)穿刺技术留置PICC,穿刺后行胸部X线摄片确认导管尖端位置。观察记录PICC留置过程及术后并发症发生情况,护理满意度。结果相比对照组患者,观察组患者PICC-DVT发生率明显更低,而护理满意度较高,差异具有统计学意义(P<0.05)。观察组内使用利伐沙班组和不使用组之间DVT差异无统计学意义(P>0.05)。结论自制心电定位系统引导PICC尖端定位,可降低PICC-DVT发生率,提高患者满意度。预防性抗凝治疗对降低PICC-DVT是否有作用尚需进一步研究。
Objective To explore the prevention against peripherally inserted central catheter-related deep vein thrombosis(PICC-DVT)using self-developed ECG guidance and oral rivaroxaban in patients with ovarian cancer.Methods Included in this study were 172 patients who needed chemotherapy following ovarian cancer surgery between January 2016 and January 2019.The subjects were randomly divided into two groups:the study group(n=87)and the control group(n=85).Further,the study group was divided into the a group given rivaroxaban after placement of PICC(rivaroxaban group,n=44)and another not given rivaroxaban(non-rivaroxaban group,n=43).All patients received six cycles of intravenous chemotherapy with docetaxel+carboplatin(DC)regimen.In the study group,a self-developed ECG guidance system was used to navigate the PICC tip.The rivaroxaban group received three-week administration of oral rivaroxaban for prophylactic coagulation theraphy starting from 24 h after PICC indwelling.In the control group,the length of PICC was estimated by advextracorporeal measurements,and a modified Seldinger puncture technique was used to indwell the PICC,followed by chest X-ray confirmation of the catheter tip after the puncture.The groups were recorded and compared for the PICC indwelling procedure,postoperative complications,and patient satisfaction about the nursing.Results Compared with the control group,the study group had significantly lower incidence of PICC-DVT and more satisfaction about the nursing,with statistical difference(P<0.05).These observation did not differ significantly between the groups with or without rivaroxaban use(P>0.05).Conclusion Use of the self-developed ECG guidance system for navigation of PICC tip may reduce the incidence of PICC-DVT and improve patient satisfaction.Further studies are warranted to validate the need for prophylactic anticoagulation in reducing PICC-DVT.
作者
褚达明
刘藤藤
栾南南
Chu Daming;Liu Tengteng;Luan Nannan(Department of Obstetrics and Gynecology,China Medical University Shengjing Hospital,Shenyang 110022,China)
出处
《中国药物与临床》
CAS
2021年第4期572-575,共4页
Chinese Remedies & Clinics
关键词
心电定位系统
利伐沙班
导管插入术
中心静脉
静脉血栓栓塞
预防
病人满意度
ECG guidance system
Rivaroxaban
Catheterization,Central venous
Venous thromboembolism
Prevention
Patient satisfaction
