Analysis Of PICC Induced Vein Thrombosis Related Factors In Cancer Patients And Changes Incoagulation Analysis

ObjectiveTo investigate the risk factors of PICC relate DVT of tumor patients and the relationship between thromboxane index and thromboembolismMethodsThere are two parts in this research. In the first part it performed a retrospective cohort study of120cancer patients who firstly received PICC intubate for the administration of chemotherapy in hospital from JAN1st to DEC31th2012.the patients will be observation10days after PICC, and will be grouped into thrombus or control depend on diagnose of DVT.Univariable and multivariable logistic regression analyses were performed to identify risk factors for PICCrelated DVT.In the second part,66cancer patients will be collected firstly using PICC tube in hospital in the same time. The patients will be observation10days after PICC, and will be grouped into thrombus or control depend on diagnose of DVT. All patients will be withdraw at the1st,4th,7th,10th days after PICC intubate, and PT, APTT, TCT, FIB, DD, PLT will be checked. Collect all the data and describe the tendency of thromboxane index, and the difference between thrombus group and control group.ResultResults of the first part indicate that kinds of complication(P<0.01), smoking(P<0.05), exercise(P<0.05), surgery treatment(P<0.01), location of intubate(P<0.05), methods of intubation(x2USG-NUSG=36.92,P<0.0001. x2USG-VC=11.43,P=0.0007. x2NUSG-VC=4.972,P=0.0258), location of the tip of tube(x2v2/3-v1/3=8.246,P=0.0041. x2v2/3-vI=5.934,P=0.0149. x2v1/3-vI=29.94, P＜0.0001) are relate tothromboembolism. Our research cannot prove age (P>0.05),gender (P>0.05) relate to thromboembolism. Multivariable logistic regression analyses indicates that diabetes(OR=4.157,P=0.019), surgery treatment(OR=3.333,P=0.037), left arm intubate(OR=2.896,P=0.047), non-ultrasonic guide intubation(OR=10.363,P<0.001) and the tip of tube locates out of1/3inferior part of superior vena cava(OR=8.597,P<0.001) are the risk factors of thromboembolism.In the second part,it found that PT at the1st,4th,7th,10th day after intubate is normal in all patients; compare with control,the PT of the thrombus group patients descend at the4th,7th and10th day(P<0,01), and the PT of thrombus group patients continually descent at every testing point(P<0,05, thrombus ldvs.10d). All patients have lower APTT level after PICC intubate at every testing points; compare to control group, the APTT of thrombus patients descend at4th,7th,10th day(P<0,01), and continually descend at every testing points(P<0,05, thrombus ldvs.10d). The FIB level of all patients are normal, there is no difference between control and thrombus. The TCT of thrombus higher than normal at the4th and7th day after intubation; compare with control, the TCT of thrombus patients increase at the4th and7th day(P4<0.01,P7<0.05thrombus vs. contral). The DD level of control groups beyond normal at the4th,7th and10th day after intubation, the DD level of thrombus group beyond normal at every testing points, compare with control, the DD level of thrombus group increase at every testing points(P1,4,10<0.01,P7<0.05,thrombus vs. contral). The PLT level of two groups are normal at every testing points, compare with control, the PLT of thrombus decrease at the7th day(P<0.01), and increase at the10th day(P<0.05).ConclusionThe first part, our research indicate that diabetes, surgery, left arm intubate,non-ultrasonic guide PICC intubation and the tip of tube locates out of1/3inferior part of superior vena cava are the risk factors of PICC related thromboembolism. The nurse should evaluate the risk of cancer patients with PICC intubation according to the risk factors mention above and prevent thromboembolism in cancer patients.]The second part of our research indicate thecontinuallydecreased PT and APTT level, and the far beyond normal DD level prognosticate the possibility of thromboembolism.