Clinical Study Of Central Venous Catheter-related Thrombosis

With the maturing of central venous catheter technology and the needs of clinical development, central venous catheter avoids the suffering of repeated puncture for patients because of its safety, simplicity, versatility, long catheterization times and other advantages, which has been widely used in clinical, especially in surgery, emergency treatment, chemotherapy, hemodialysis and critically ill patients. With the widespread used of central venous catheter technology, its related complications are also gradually being recognized by the clinical medical workers, such as central venous catheter-related infections, catheter-related thrombosis. The symptomatic catheter-related thrombosis is the serious complication, and even lead to pulmonary embolism thrombi, not only increase the medical risk and the cost of hospitalization, but also to bring the physical and mental burden on patients and their families. This study was designed to research and analysis for the incidence and risk factors of central venous catheter-related thrombosis, in order to enhance the understanding of the central venous catheter-related thrombosis and reduce catheter-related thrombosis complications for the central venous catheter being selected and used safer, extensive and rational in clinical.Objective: To study the incidence of central venous catheter-related thrombosis, and the impacting of gender, age, catheter site, type of disease(benign or malignant), prophylactic anticoagulant therapy and other factors with catheter-related thrombosis, in order to enhance the understanding of the central venous catheter-related thrombosis and reduce catheter-related thrombosis complications, to provide a theoretical basis for selecting and using central venous catheter safer and widely in clinical.Methods: 154 patients that indwelling central venous catheter after surgery in General Surgery Dept.2 of Hebei People’s Hospital from Jan 2014 to Feb 2015 were collected. The general clinical data of all patients were collected, including name, gender, age, type of diseases(benign and malignant), catheter site, intubation and extubation time, with or without prophylactic anticoagulant therapy and complications. All patients accepted CDFI before extubation, and they were divided into thrombosis positive or negative groups based on the results of CDFI. The thrombosis positive group as the observation group, the thrombosis negative group as a control group. Analysis the incidence of catheter-related thrombosis and whether there are differences between the two groups were compared by sex, age, catheter site, type of disease(benign or malignant), prophylactic anticoagulation and other factors. Univariate count data were compared using χ2 test, and then take the univariate analysis derived significant variable for logistic regression analysis, screening out the independent risk factor of catheter-related thrombosis. P <0.05 indicated that the difference was statistically significant.Results: There were 154 Patients in the collection, including 96 cases of male(62.3%), female 58 cases(37.7%), age from 18 to 87 years, the average age 59.24±15.18 years old, The number of the patients who formed of catheter-related thrombosis was 68, that didn’t formed was 86, the incidence of catheter-related thrombosis was 44%.By univariate analysis χ2 test, 4 factors were screened out:gender, age, cather site, type of disease(benign or malignant), which related to the catheter-related thrombosis(P<0.05), Through multivariate logistic regression analysis futher screening found gender, age, cather site were significantly affecting catheter-related thrombosis. Comparison of catheter-related thrombosis incidence(P<0.05 was significant): Male had a 3.007-fold than female, P=0.004; patients older than 60 y had a 1.775-fold than younger ones, P=0.018; The right internal jugular vein catheterization had a 3.808-fold than the subclavian vein catheterization, P <0.001.Conclusion: 1 Central venous catheter-related thrombosis is extremely high, and it is much more obvious with the longer time. 2 There facors: gender, age, cather site, which closely related to the catheter-related thrombosis, more rates in male than female, more rates in patients older than 60 y than younger, more rates in the internal jugular vein catheterization than the subclavian vein catheterization.