Study On The Related Factors Between Golden Blade Injury And Thrombosis After Central Venous Catheter Catheterization

Objective: To explore the correlation between golden blade injury(central venous catheter)and catheter related venous thrombosis(CRT),and provide clinical basis for effectively preventing and controlling CRT and reducing its incidence.Methods: In this study,patients with lung cancer and colorectal cancer who received p ICC/CVC catheterization in central Department of Oncology,Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from January 2021 to January 2023 were selected,and the data were collected from electronic case database.patients with CRT were included in the thrombus group,while those without CRT were included in the non-thrombotic group.General data,catheterization data,biological indicators,TCM syndrome types and other information of the two groups of patients were collected.The retrospective case-control study method was used to compare the information of the two groups of patients,study the influencing factors of CRT after catheterization,and analyze the distribution of TCM syndrome types.Results:1.Data: According to the inclusion and exclusion criteria,a total of 181 patients were included,including 27 patients in the thrombus group(CRT group)and 154 patients in the non-thrombotic group(no CRT group).2.The relationship between the incidence of CRT and general information:there were 14 cases(51.85%)of BMI≥24kg/m2 in the thrombus group,and28 cases(18.18%)of BMI≥24kg/m2 in the non-thrombus group.Statistically,the proportion of BMI≥24kg/m2 in the thrombus group was significantly higher(P < 0.05,OR=10.347).13 patients in the thrombus group(48.15%)had a smoking history,and 8 patients in the non-thrombus group(5.19%)had a smoking history.Statistically,the proportion of patients in the thrombus group with a smoking history was significantly higher(P < 0.05,OR=4.86).In the thrombus group,9 cases(33.33%)were complicated with diabetes,and in the non-thrombus group,10 cases(6.49%)were complicated with diabetes.Statistically,the proportion of patients with diabetes in the thrombus group was significantly higher(P < 0.05,OR=5.388).There was no correlation between the incidence of CRT and gender,age,hypertension and coronary heart disease(P > 0.05).3.The relationship between CRT incidence and catheterization: 13 cases(23.2%)of PICC catheterization and 14 cases(11.2%)of CVC catheterization in thrombus grou P were found to have a higher incidence of CRT than CVC in PICC catheterization(P < 0.05,OR=3.37).In the thrombus group,there were 8 cases(61.54%)of PICC catheterization in the left upper limb and 5cases(38.46%)in the right upper limb.The incidence of CRT in the left upper limb of PICC catheterization was significantly higher than that in the right upper limb(P < 0.05).There was no correlation between the incidence of CRT and the placement site of CVC(P > 0.05).4.The relationship between the incidence of CRT and coagulation index: the D-D level in the thrombar group was significantly higher than that in the non-thrombar group(P < 0.05,),and the D-D level was an independent risk factor for CRT in patients with lung cancer and colorectal cancer after catheterization by multivariate analysis(OR=1.315).There was no correlation between CRT incidence and PT,APTT and FIB coagulation index(P > 0.05).5.The relationship between the incidence of CRT and the TCM syndrome type: the TCM syndrome type distribution of patients in the thrombi group was as follows: lung cancer: Qi stagnation and blood stasis syndrome > lung qi Qi deficiency syndrome > Qi Yin deficiency syndrome > phlegm-heat obstructive lung deficiency syndrome > lung Yin deficiency syndrome.The proportion of patients with Qi stagnation and blood stasis syndrome was significantly higher than that with non-Qi stagnation and blood stasis syndrome(P < 0.05).Colorectal cancer: syndrome of Qi stagnation and blood stasis > syndrome of Qi and blood deficiency > syndrome of spleen and kidney Yang deficiency > syndrome of dampness-heat accumulation >syndrome of liver and kidney Yin deficiency,the proportion of patients with syndrome of Qi stagnation and blood stasis was significantly higher than that without syndrome of Qi stagnation and blood stasis(P < 0.05).It is concluded that the syndrome of qi stagnation and blood stasis in lung cancer and colorectal cancer is correlated with the incidence of CRT.The syndrome of Qi stagnation and blood stasis was an independent risk factor for CRT after catheterization of lung cancer and colorectal cancer by multivariate analysis(OR=4.126).6.Relationship between Qi-stagnation and blood-stasis syndrome and coagulation index: The median D-D values of Qi-stagnation and blood-stasis syndrome and non-Qi-stagnation and blood-stasis syndrome of lung cancer were 2.22ug/ml and 1.24ug/ml,respectively.The D-D level of Qi-stagnation and blood-stasis syndrome was higher than that of non-Qi-stagnation and blood-stasis syndrome(P < 0.05),and had no correlation with PT,APTT and FIB(P > 0.05).The median D-D values of Qi-stagnation and blood-stasis syndrome and non-Qi-stagnation and blood-stasis syndrome in colorectal cancer patients were 2.73ug/ml and 0.73ug/ml,respectively.The D-D level of Qi-stagnation and blood-stasis syndrome was significantly higher than that of non-Qi-stagnation and blood-stasis syndrome(P < 0.05),and there was no correlation with PT,APTT and FIB(P > 0.05).Cconclusion:1.BMI,smoking history,diabetes mellitus,catheterization method,catheterization site,and D-dimer are related factors affecting the occurrence of CRT after golden blade injury(central venous catheter catheterization)in Patients with lung cancer and colorectal cancer.2.The syndrome of qi stagnation and blood stasis is more common in lung cancer and colorectal cancer patients with CRT.