Risk Factors Of Deep Venous Thrombosis In Blood Perfusion Patients And The Corresponding Strategies

Purpose: The research studies the morbidity and related risk factors for the forming of deep venous thrombosis for poisoning patients with central venous catheterization in order to carry out hemoperfusion,so as to find out corresponding intervention measures.Method: First,a retrospective investigation has been carried out to study the morbidity and onset time for the forming of deep venous thrombosis for acute poisoning patients who has gone through temporary venous catheterization in order to carry out hemoperfusion at the Emergency Department at Affiliated Hospital of Binzhou Medical College from January,2015 to December,2015,and record the catheter operator,the catheter retention time,the anti-coagulant compliance situation during the hemoperfusion,times of perfusion,the APTT index within 24 hours after extubation,and the forming of thrombosis after extubation.Second,the correlations between the incidence and gender,age,the catheter retention time,times of perfusion and the anti-coagulant compliance situation,as well as the risk factors are analyzed.Then,intervening factors are adopted in the intervention test,and the incidence and the situation of bleeding complications of patients in both the treatment group and the observation group are observed to compare the effect of intervention.Result: 1.A total of 144 cases of patients have been studied in the retrospective investigation,among whom,69 cases are male and 75 cases are female.28 cases of patients are reported deep venous thrombosis,the morbidity is 19.4%;25 cases of patients are reported deep venous thrombosis before extubation,which account for 17.4%;3 cases of patients are reported deep venous thrombosis after extubation,which account for 2.1%.2.There is an obvious temporal correlation about the morbidity of catheter related deep venous thrombosis.The morbidity increases obviously as catheters stay longer.3.There is a correlation between the frequency of perfusion and catheter related deep venous thrombosis.The morbidity increases as the frequency increases.4.There are 108 patients meeting the standard of anticoagulation during the period of blood perfusion and 12 of them having attacks;there are 36 patients not reaching the standard and 13 of them having attacks.The morbidity difference is obvious(P<0.05)5.There 3 pa tients getting deep venous thrombosis after catheter removal with APTT?38.6s during 24 hours.6.There are 131 patients picked finally in the intervention treatment with 8 of them having thrombus.Before catheter removal,strengthened anticoagulation monitoring group of the intervention group has a higher rate of reaching anticoagulation standard than the control group and a lower morbidity of deep venous thrombosis,P<0.05.7.There are 123 patients in the intervention treatment group after extubation without deep venous thrombosis(DVT),and 119 patients in the control group with 4 have attacks.Stratified analysis showed that there is morbidity difference between these two groups,P<0.05.8.There is no result about the influence of age,sex and puncture on the morbidity of deep venous thrombosis.9.In the interventions experiment,no s ignificant difference of the morbidity of bleeding events is found between the experimental group and the control group no matter before or after extubation.Conclusion: 1.The morbidity of catheter related deep venous thrombosis related with central venous catheterization and hemoperfusion in poisoning patients is 19.4%.2.Non-complying anticoagulation,excessive catheter indwelling time,many perfusion times,and excessively low APTT within 24 hours after the extubation were the risk factors for the deep venous thrombosis in patients who received blood perfusion and peripherally inserted central catheter due to poisoning.3.In this research,gender and age factors are not found to be associated with the morbidity of catheter related deep venous thrombosis.4.Strengthening the monitoring of anticoagulation during hemoperfusion can effectively improve the compliance rate and reduce the morbidity of catheter related deep venous thrombosis.5.Injecting subcutaneous low molecular weight heparin on the patients whose APTT is less than or equal 38.6S in the 24 hours after extubation can effectively prevent deep venous thrombosis.