Clinical Features Of Occlusion In Cancer Patients With PICCs

Objective1.To investigate the multiple sites of PICC occlusion in patients with cancer;2.To calculate the area of PICC occlusion in patients with cancer;3.To analyze the relationship between the area of PICC occlusion and indwelling time in patients with cancer;4.To analyze the risk factors for PICC occlusion in patients with cancer.Methods1.Selected the catheters of patients in Jiangsu Caner Hospital who had PICC occlusion when coming for catheter maintenance or during their hospitalization,and patients who had their last infusion,dripped to a maximum and less then 50 drops per minute before extubation within December 2016 to November 2017.The catheters were made into sections in order to observe the multiple sites of PICC occlusion;2.After making the sections,using the ImageJ software to draw the outline of the materials in the catheters on the sections in order to calculate the area of PICC occlusion.The area would be divided into grades according to different ranges and analyzed the relationship combine with the catheter indwelling time;3.The patients collected were divided into observation group and control group according to whether there was material in the catheters,these patients would be investigated by consulting their cases,answering survey and telephone follow-up to obtain their information.Univariate and multivariate analyses were used to analyze the independent risk factors for PICC occlusion.Results1.A total of 19 sections were made in the study,and 90 patients were eventually included.Material was found in the catheters of 50 patients while 40 patients had none in their catheters on the sections.The multiple site of PICC occlusion is the tip of catheters by observing;2.After calculating the PICC occlusion area and analyzing the relationship with time by Spearman rank correlation analysis,no correlation was found between occlusion area and indwelling time(P>0.05);3.Univariate analysis demonstrated that BMI,basic diseases,D-dimer,maintenance cycle,catheter-related complications,and cough had a statistically significant effect on the PICC occlusion(P<0.05);4.Logistic regression analysis demonstrated that D-dimer(OR=0.214,P=0.010,95%CI=-3.369?-0.561),catheter-related complications(OR=1.525,P=0.033,95%CI=0.041?1.004),cough(OR=0.250,P=0.013,95%CI=-3.009?-0.292)were independent risk factors of PICC occlusion.Conclusion1.PICC catheters can be made into sections for detection,and the distribution of material in the catheters can be observed visually;2.After calculating the area of PICC occlusion and analyzing the correlation with indwelling time,no correlation was found between these two;3.BMI,basic diseases,D-dimer,maintenance cycle,catheter-related complications,and cough had a statistically significant effect on the PICC occlusion,but D-dimer,catheter-related complications,and cough were the independent risk factors of PICC occlusion.