摘要目的分析生理节律对PICC置管相关静脉血栓形成的影响。方法在2015年1月～2016年6月于我院行外周静脉置入中心静脉导管（PICC）的恶性肿瘤患者中随机抽取180例，根据患者静脉置管时间进行分组，两组患者在超声引导下置入PICC管行贵要静脉或肱静脉穿刺，观察组90例下午15:00～17:00置管，对照组90例上午8:00～10:00置管。结果观察组静脉血栓发生率明显低于对照组（4.44%vs 18.89%）（P<0.05），静脉血栓严重程度较对照组轻（Ⅱ级1.11%vs 7.78%，Ⅲ级0 vs 6.67%）（P<0.05）。两组患者的并发症发生率比较，差异无统计学意义（P>0.05）。结论不同时间段对患者行PICC置管后的静脉血栓发生率不同。血液低凝时间窗（午后15:30左右）下行PICC置管对比血液高凝时间窗（清晨6:00至中午）行PICC置管可减少静脉血栓的形成。
Abstract：ObjectiveTo analyze the influence of physiological rhythm on venous thrombosis associated with peripherally inserted central catheterization (PICC).MethodsFrom January 2015 to June 2016,180 patients were randomly selected from patients with malignant tumor and given PICC catheterization in our hospital and they were divided into two groups according to their venous catheterization time.Under the ultrasound guidance,basilic vein or brachial vein puncture in two groups were conducted after inserting PICC tube.In the observation group (n=90), catheterization was carried out from 15:00 to 17:00,while in the control group,itwas from 8:00 to 10:00.ResultsIn the observation group,the incidence rate of phlebothrombosiswas obviously lower than that in the control group (4.44%vs 18.89%)(P<0.05),and the severity of venous thrombosiswasmilder than that in the control group (gradeⅡ1.11%vs 7.78%,gradeⅢ 0 vs 6.67%) (P<0.05).The incidence rate of complication between two groups had no statistical differenc (P>0.05).ConclusionThe incidence rate of venous thrombosis after PICC catheterization is different in different time period.In comparison of PICC catheterization performed during the low-coagulation time window(around 15:30 in the afternoon)and hypercoagulable time window (from 6:00 of early morning to noon),the former one can decrease the incidence of venous thrombosis.
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