Study on risk factors of catheter-related venous thrombosis and prevention effect of low-molecular-weight heparin in patients with hematological malignancies
10.3760/cma.j.issn.1006-9801.2019.10.008
- VernacularTitle: 血液恶性肿瘤患者导管相关静脉血栓形成的危险因素及低分子肝素预防作用研究
- Author:
Jianyun LI
1
;
Chuanqing TU
;
Ling PENG
;
Can HUANG
;
Xuyan ZHANG
;
Dianwen WANG
;
Caifeng ZHENG
Author Information
1. Department of Hematology, Baoan District People's Hospital of Shenzhen City, Shenzhen 510108, China
- Publication Type:Journal Article
- Keywords:
Hematologic neoplasms;
Peripherally inserted central catheter;
Antithrombin Ⅲ;
Protein C;
Protein S;
Catheter-related thrombus
- From:
Cancer Research and Clinic
2019;31(10):679-683
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and risk factors of catheter-related venous thrombosis (PICC-DVT) after peripherally inserted central catheter (PICC) in patients with hematologic malignancies, and to analyze the safety of anti-coagulation therapy with low-molecular-weight heparin.
Methods:From August 2016 to June 2018, 43 patients with hematologic malignancies received PICC in Baoan District People's Hospital of Shenzhen City were enrolled. The patients were divided into low-molecular-weight heparin anticoagulation group (22 cases) and blank control group (21 cases) according to the random number table method. The blood routine, coagulation quadruple, D-dimer, protein C activity, protein S activity, and antithrombin Ⅲ activity before and after catheterization were compared between the two groups.
Results:Of the 43 patients, 5 cases (11.62%) occurred PICC-DVT within 1 month after PICC, including 2 cases (9.09%) in the low-molecular-weight heparin anticoagulation group, and 3 cases (14.29%) in the blank control group, the difference between the two groups was not statistically significant (P = 0.664). No pulmonary embolism occurred in all patients with PICC-DVT. One case in the blank control group developed PICC-DVT and catheter-associated staphylococcus aureus infection, the patient was extubated after anti-infection and thrombolytic therapy, the other patients with PICC-DVT were not extubated, and the thrombus was dissolved after anticoagulant therapy. There were no significant differences in the white blood cell count, platelet count, prothrombin time, activated partial thromboplastin time, D-dimer, protein C activity, protein S activity, and antithrombin Ⅲ activity between the low-molecular-weight heparin anticoagulation group and blank control group (all P > 0.05). The anticoagulant index (protein C, protein S or antithrombin Ⅲ activity) was decreased in 5 patients with PICC-DVT, and in 38 non-thrombotic patients, the anticoagulant index was reduced in 16 patients (42.11%), the difference was statistically significant (P = 0.021).
Conclusions:The incidence of protein C, protein S or antithrombin Ⅲ activity reduction in hematological malignancies patients with PICC-DVT is higher than that in non-thrombotic patients. Low-molecular-weight heparin anticoagulant therapy can not reduce the occurrence of PICC-DVT within 1 month after PICC in patients with hematological malignancies, but the treatment is safe and has no relevant bleeding event.
