| Objective To investigate effects of watering tubes with heparin saline in differ time interval for catheter related thrombosis on postoperative gastric cancer clients. To find out more effective implementations of preventions in catheter related thrombosis, and do not increase the watering tubes interval time of surgical or other catheter related complications. To study the effect factors of central veins catheter related thrombosis in gastric cancer clients, and provide a scientific recommendation for medical staffs about central veins catheter related thrombosis prevention after surgery.Methods From August2012to December2011,120postoperative gastric cancer clients met criteria were included in study and were randomly assigned to four groups. The interventions of four groups respectively are as follow:normal care base on Central Venous Catheter (CVC)(A group); in addition, the rest of groups are watering tubes with heparin saline by20ml62.5unit/ml per four hours followed the rhythm of fast-slow-fast (B group); watering tubes with heparin saline by20ml62.5unit/ml per eight hours followed the rhythm of fast-slow-fast (C group); and watering tubes with heparin saline by20ml62.5unit/ml per twelve hours followed the rhythm of fast-slow-fast (D group). By observed the condition of thrombosis, indexes of blood coagulation, time of catheter transfusion, catheter duration, and average daily catheters usage, etc. we applied t-test or variance analysis when quantitative statistics follow a Normal distribution or homogeneity of variance, rank-sum test when heterogeneity of variance, chi-square test as counting data, and multi-factor Logistic regression analysis, etc. to analyze the incidence of catheter related thrombus and effect factors of thrombosis.Results1. The total incidence of thrombus in120cases both exterior and interior catheter related thrombus (68.3%) is higher than it reported by scholars at home and abroad research.2. The comparison of incidence of interior catheter related thrombus in all120cases respectively40%,10%,20%,46.7%, it showed statistically difference(P<0.05). Moreover, the lowest incidence of interior catheter related thrombus in B group compare with the rest groups; differences among the groups were statistically significant.(P<0.0083)3. Compared with the incidence of exterior catheter related thrombus respectively (56.7%,53.3%,63.3%, and66.7%) among four groups showed no statistically significant difference.(P>0.05)4. Compared with the total incidence of thrombus both exterior and interior catheter related thrombus respectively (70%,56.7%,70%,76.7%) among four groups showed no statistically significant difference.(P>0.05)5. The catheter related thrombosis in postoperative gastric cancer clients related to postoperative mean daily catheter transfusion, catheter duration, age and gender, etc. however, mean daily catheter usage is a protect factor, while age, catheter duration and male are the risk factors.Conclusion1. The study demonstrates that the incidence of central venous catheter related thrombus in gastric cancer is higher than it and other diseases reported by scholars at home and abroad research. It may relate to the cases choose only by surgical therapy in gastric cancer clients. It suggest that clinical staff should strengthen care of postoperative gastric cancer clients with central venous catheterization, and prevent catheter related thrombosis.2. Base on the steady speed of transfusion, application of impulsive watering tubes with heparin saline every four hours might contribute to prevent catheter related thrombosis in postoperative gastric cancer clients with central venous catheterization and do not increase incidence of postoperative bleeding, which are worthy spreadly apply to clinical.3. Impulsive watering tubes with heparin saline do not effectively prevent exterior catheter related thrombosis. It might verify by further study on increase size of sampling.4. For postoperative gastric cancer clients with central venous catheterization, and base on steady speed of transfusion, we consider that practitioners should enhance care of elderly people and male. To the short time of mean daily catheter used clients, it would not suggest long time catheterization to avoid of thrombosis. |
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