Research Of Correlative Factors In Durative Staxis And Phlebitis Of Acute Leukemia Patients With PICC

ObjectiveTo investigate the risk factors in durative staxis and phlebitis of acute leukaemia patients with PICC and use effective preventive nursing measures.MethodThe first portion:Patients first diagnosed as acute leukaemia and first using Peripherally Inserted Central Catheters(PICC) recruited from November,2007 to October,2008 in the leukaemia department,Blood Disease Research Institute, Chinese Academy of Medical Science.All patients were observed for 72h.According to the diagnostic criterion of durative staxis,patients were divided into durative staxis group and control group.Anxious emotion was assessed by questionnaire S-AI. Information on patients and data(including plt,PT,APTT,TT,serus ca level) were colleted.All data were analyzed by SPSS 11.5.The different factors which lead to durative staxis were analyzed by Chi-square test and t-test.Logistic regression model were used for multivariate analysis.The second portion:Patients diagnosed as acute leukaemia who first used Peripherally Inserted Central Catheters(PICC) recruited at the same time.Patients were observed for 3 months.According to the diagnostic criterion of phlebitis, patients were divided into phlebitis group and control group.Durative anxious emotion was assessed by questionnaire T-AI.Information on patients and data (including WBC,N,IgG,)were colleted All data were analyzed by the statistic software of SPSS 11.5.The different factors which lead to phlebitis were analyzed by Chi-square test and t-test.Logistic regression model were used for multivariate analysis.Result:The first portion:The results of univariate analysis showed that platelet counts (t=3.807,P=0.000),simple erythrocyte transfusion before insertion of PICC (x~2=5.735,P=0.017) and patients emotion(x~2=4.538,P=0.033) were associated with durative staxis.Meanwhile,gender(x~2=2.256,P=0.133),age(x~2=2.627,P=0.105), prothrombin time(x~2=1.154,P=0.283),activated partial thromboplastin time(x~2= 1.154,P=0.283),TT(x~2=0.323,P=0.570),serus ca level(t=0.829,P=0.414) were not associated with durative staxis.The results of multivariate logistic regression analysis showed that platelet counts(OR=0.269,95%CI:0.095～0.766) was the protective factor of durative staxis.Simple erythrocyte transfusion before inserting PICC(OR=5.236,95%CI:1.407～19.490) and anxious emotion(OR=6.497,95%CI: 1.237～34.129) were the risk factors.The second part:The results of univariate analysis showed that location of inserted vein(x~2=10.252,P=0.006),inserting vein number(x~2=10.424,P=0.001), activity of inserted limb(x~2=6.810,P=0.009),elbow bending(x~2=6.178,P=0.013), blood sugar level(t=-2.499,P=0.015) and emotion(x~2=6.023,P=0.014) were associated with phlebitis.Meanwhile,gender(x~2=0.104,P=0.747),age(x~2=1.913, P=0.384),type of acute leukaemia(x~2=0.002,P=0.962),allergic habitus(x~2=0.316, P=0.574),immune function(x~2=3.113,P=0.078),WBC(t=1.421,P=0.159),N (t=-1.111,P=0.270) were not associated with phlebitis.The results of multivariate logistic regression analysis showed that basilica vein was the protective factor. Multiple insertings,more activity of inserted limb,durative anxious emotion were the risk factors.ConclusionThe first part:Low platelet counts,simple erythrocyte transfusion and anxious emotion are the risk factors of durative staxis.Therefore patients can reduce the occurring of durative staxis by well estimating platelet,only erythrocyte transfusion or not before insertion of PICC and patient' emotion state and by take nursing measures.The second part:Different location of vein,limb motion,high blood sugar level and persistent anxious emotion are the risk factors of phlebitis.These factors should be paid more attention to avoid phlebitis by taking correspondent nursing measures and good maintenance of PICC.