Relation Of Central Venous Catheterization And Deep Venous Thrombosis

Objectives Central venous catheter was accepted by many patients with its safe,convenient, longer catheter time,less pain.It is not only a rapid infusion for treatmentguidance channel, but also can monitor the central venous pressure, pulmonary capillarywedge pressure, It is an important part of modern clinical therapeutics indispensable.However, with the central venous catheter is more and more widely used in clinical, itsside effects are also gradually revealed. Clinical symptoms due to formation of catheter-related thrombosis is not significant, it is very difficult to diagnose. Even the pulmonaryembolism which is the most critical complications of the deep vein thrombosis, itsdiagnosis rate is very low. Clinical deaths caused by catheter thrombosis reported moreand more. The purpose of this study is to observe thrombosis dynamically in patientsafter central venous catheter, to provide a theoretical basis for the prevention andtreatment of thrombosis in people at high risk in future.Methods Through the inclusion and exclusion criteria in China Mei tan General Hospitalfrom2010January to2013December collect330patients after central venous catheter.Record the patient’s name, gender, age, type of disease. Understand the patient’s cardiacfunction, whether for multiple organ failure, ever line operation, whether there is risk ofdiabetes, cancer and other factors. Record the date, location, catheter depth. According tothe age, the catheter and the use of anti coagulation (heparin, low molecular weightheparin, Hua Faling), anti platelet agents (aspirin, Plavix group) to observe the changes ofthe patients blood coagulation, platelet, D-dimer at different time. And to determine thethrombosis Combining heart and vascular ultrasound limbs.Result1). Compared with the catheter before, the platelet count, platelet hematocrit, D-dimer, fibrinogen increased to different degree after catheter, and prothrombin activitywas significantly decreased (P＜0.05). The difference was statistically significant.2).Less than or equal to60year old age group, catheter after2weeks platelet count,hematocrit was significantly higher than Catheter before, higher than catheter after1weeks (P＜0.05). Catheter after1weeks,2weeks,3weeks of D-dimer is significantlyhigher than Catheter before (P＜0.05).3).60to80year old age group, catheter after3weeks platelet count, hematocrit was significantly higher than Catheter before, higherthan catheter after1weeks (P＜0.05).Catheter after1weeks of D-dimer is significantlyhigher than catheter before (P＜0.05).4). More than80year old age group, Catheter after 3weeks of D-dimer was significantly lower than Catheter after1week (P＜0.05).5).Femoral vein catheter group, catheter after2weeks,3week platelet count, wassignificantly higher than Catheter before, higher than catheter after1weeks. catheterafter2weeks, hematocrit was significantly higher than Catheter before, higher thancatheter after1weeks (P＜0.05). Catheter after1weeks,2weeks,3weeks of D-dimerwas significantly higher than that of catheter before (P＜0.05).6). Subclavian vein grope,Catheter after1weeks,2weeks,3weeks of fibrinogen was higher than catheter before,and Catheter after2weeks was higher than catheter after1weeks (P＜0.05).Catheterafter1weeks,2weeks,3weeks of D-dimer was significantly higher than that of catheterbefore (P＜0.05).Comparison between groups, after catheter femoral vein group D-dimeris significantly higher than that of subclavian vein (P＜0.05).7).The use ofanticoagulants, anti platelet drug group. The use of anti platelet drug group, Catheter after1weeks,2weeks of D-dimer is higher than Catheter before (P＜0.05).Do not usemedicine group, catheter after2weeks,3week platelet count was significantly higherthan Catheter before, higher than catheter after1weeks. Catheter after2weekshematocrit was significantly higher than Catheter before, higher than catheter after1weeks (P＜0.05).Catheter after1weeks of fibrinogen is higher than catheter before (P＜0.05).Catheter after1weeks of D-dimer is higher than catheter before (P＜0.05).8). Inthe330cases patients of central venous catheter, DVT30, The incidence rate is9.09%.9).The catheter position has great effects on DVT, femoral vein thrombosis rate wassignificantly higher than that of subclavian vein (P＜0.05).Conclusion1). After central venous catheter, body is in a hypercoagulable state,increased the incidence of thrombosis.2). The catheter position is significant correlationwith DVT, femoral vein thrombosis rate was significantly higher than that of subclavianvein.3). Application of anticoagulant, antiplatelet drugs did not reduce the incidence ofthrombosis.