The Study Of Central Venous Catheters Related Thrombosis

Objectives: to study the initial time and the related risk factors of centralvenous catheters related thrombosis(CRT),compare the difference amongdifferent locations; observe perioperative PLT, coagulation function,D-dimerand the catheter-related thrombosis with bedside ultrasonography dynamicly;toknow the incidence rate of pulmonary embolism in CRT patients;to provideevidence for clinical workers deciding the reasonable removing time of CVC.Methods:107patients after surgery in the general surgical and cardiothoracicdepartments in First Affiliated Hospital of GuangXi Medical University wereenrolled: we recorded the general properties, primary treatment and indwellingtime, and test the PLT, coagulation function, D-dimer, observed thecatheter-related thrombosis with bedside Ultrasonography dynamicly and if anypulmonary embolism occur during the catheters indwelling, the patients withcomplete obstructive thrombosis were received CTPA with the patients’permission to know if pulmonary thromboembolism exist.Results:The incidence of catheter-related thrombosis at3th,5th7thday afterindwelling were65.4%，83.8%，90.9%respectively, and IJC:69.3%， 83%，87%;SVC:33%，55%，100%;3(2.8%)IJC patients got completeobstructive thrombosis, no PTE on CTPA of2patients.The comparison ofthrombotic ratio between IJC and SVC on3th,5thday were χ2=7.209，P=0.007（P<0.05is significant）and χ2=3.635，P=0.057（P<0.05is significant）.Sex,age older than60y and catheter types were significant factors that due toCRT (P<0.05): Female had a0.263-fold(P=0.017) than male; patients olderthan60y had a0.268-fold(P=0.041) than younger ones；type2catheter had a0.034-fold (P=0.003) increased risk thrombosis. Perioperative PLT,PT,D-dimeret al had no significance for CRT.Conclusion: CRT is extremely high even in the early stage after catheterindwelling, and it is much more obvious with the longer time. Anticoagulantcan decrease the incidence of CRT. Sex(female)，age, catheter type are the riskfactors for CRT. Although pulmonary embolism induced by CRT is extremelylow, but it is still not clear completely that how important the non-symptomaticCRT is and the clinicians should prepare for treating it after removing thecatheters.