Incidence And Related Factors Of Central Venous Catheter-related Thrombosis After Lung Cancer Surgery

Research purposeThis study collected central vein catheters that were placed in deep veins in patients with lung cancer after common diseases in thoracic surgery.By observing the formation of thrombi in and around the catheter,the incidence of catheter-related thrombosis was counted,and the impact of catheter-related thrombosis was analyzed In the future clinical work,intervention of influencing factors can reduce the incidence of intracatheter thrombosis and prevent serious complications caused by catheter-related thrombosis.Materials and methods1.Collect 186 lung cancer patients who were admitted to our hospital in thoracic surgery from January 2018 to January 2020,undergoing surgical treatment and indwelling the central venous catheter.A total of 186 patients were treated with central venous catheterization after the central venous catheter was removed.Observe and record the presence or absence of blood clots.2.The patients with indwelling central venous catheters were divided into two groups according to the presence or absence of thrombus in the catheter,with and without thrombus group,and the clinical data were analyzed and analyzed.The clinical data included age,gender,weight,Lung cancer mass size,pathological type,lymph node metastasis,surgical methods,lung cancer-related tumor markers,preoperative coagulation indicators,D-dimer,blood glucose,blood lipids,intraoperative blood loss,postoperative white blood cell,platelet levels,and catheterization time,Location of catheterization,combined with other diseases,combined with other surgical history,and smoking history.3.SPSS 24.0 software was used for statistical analysis of the data.The collected clinical data was tested for normality by using KS test.The measurement data showing a normal distribution was expressed by mean ± standard deviation(X ± S).T test for two independent samples;non-normally distributed data are expressed as median and interquartile range[M(Q25,Q75)],Wilcoxon sign rank sum test is used for validity test;count data is used as frequency(%),Chi-square test is used for validity test,and the influencing factors are analyzed by single-factor analysis and logistic multi-factor analysis.The test standard ?=0.05 is used to draw conclusions.ResultsIn 186 cases of central venous catheterization in patients with lung cancer after operation,the observation of central venous catheterization revealed that 104 cases included in-tube thrombus and peritubular fibrin sheath formation,and the incidence of thrombosis was 55.9%.There were 5 cases of premature extubation due to catheter blockage,1 case of postoperative pulmonary embolism,and 0 cases of central venous catheter extubation syndrome.Univariate analysis of the thrombus group and non-thrombosis group showed that age,gender,weight,diseased site,pathological type,maximum diameter of the tumor,combined lymph node metastasis,preoperative LDL,APTT,PT,INR,and intraoperative blood loss,Postoperative HCT,white blood cell volume,CA199,NSE,CA125,CEA,CA211,CA153,the type of tube,the position of the tube,the length of the tube and the history of other diseases were not significantly different between the two groups(P>0.05)The number of catheterization days,preoperative blood glucose,HDL,total cholesterol,fibrinogen levels,postoperative platelets,surgical methods,and smoking history were related to central venous catheter-related thrombosis,and the differences were statistically significant(P<0.05).Days of catheterization,preoperative HDL,D-dimer,fibrinogen level,total cholesterol,postoperative blood glucose,platelet count,surgical method,and smoking history(P<0.05)were included in the binary logistic regression equation.Total cholesterol,HDL,D-dimer,blood glucose,postoperative platelet level and surgical method P>0.05 were not statistically significant and could not be explained as independent risk factors for central venous catheter-related thrombosis.The number of days of tube placement,fibrinogen level,and smoking history were statistically significant at ?=0.05.The P values were P=0.042,P=0.002,and P=0.008,and the regression coefficient of the tube placement time was 0.111.The tube placement time and CVC were The incidence of thrombosis is positively correlated.The longer the catheterization time,the greater the probability of central vein catheterization.OR=1.117,95%CI[1.004,1.243].For each unit increase in catheterization time,the risk increases by 1.117 times.The regression coefficient of fibrinogen level is 0.459.The fibrinogen level is positively correlated with the incidence of CVC thrombosis.The higher the fibrinogen level,the higher the risk of central venous catheter thrombosis.For each unit increase in the fibrinogen level,the risk increased by 1.583 times.Smoking history with smoking history as a control regression coefficient was=1.408,OR=0.245,95%CI[0.110,0.541].The risk of developing CVC-related thrombosis in non-smokers was 0.245 times that of smoking patients.Conclusion1.The incidence of central venous catheter-related thrombosis after lung cancer is 55.9%,but the incidence of serious and fatal complications has not increased correspondingly.2.Central venous catheterization time,fibrinogen level,and smoking history are independent risk factors affecting central venous catheter-related thrombosis after lung cancer surgery.