肝素钠封管对经外周静脉置入中心静脉导管肺癌患者血栓前状态的影响

Effects of heparin sodium on the prethrombotic state in lung cancer patients with peripherally inserted central catheter

摘要:

目的：探讨在经外周静脉置入中心静脉导管（peripherally inserted central catheter，PICC）的肺癌患者中，用肝素钠（125 U/ml）稀释液进行封管对其血栓前状态的影响。方法：随机抽取我科20例PICC肺癌患者，在置管后采用肝素钠稀释液进行封管，通过对PICC置管前0~1 d（T0期）、置管后2~3 d（T1期）与血栓形成相关量化指标凝血酶原时间（prothromhin time，PT）、部分活化凝血酶原时间（activated partial thromboplsatin time，APTT）、凝血酶时间（thrombin time，TT）、纤维蛋白原量（fibrinoge，Fbg）、血小板（platelet，PLT）、纤维蛋白降解产物（Fibrinogen degradation products，FDP）以及 D-二聚体的动态检测，对比T0期与T1期各项指标的变化。结果：T0与T1比较，置管前后PLT、 D-二聚体值有统计学差异（t=2.387，P=0.028；t=2.487，P=0.022），而PT、APTT、TT、Fbg、FDP统计学差异不明显。结论：①对PICC置管肺癌患者用肝素钠（125 U/ml）稀释液封管是安全的。②PICC置管肺癌患者用肝素钠（125 U/ml）稀释液封管，PLT、 D-二聚体值均呈下降趋势，对预防PICC血栓形成有一定影响意义。

Abstract:

Objective：To study the effect of heparin sodium（125 U/ml） for locking on the prethrombotic state in lung cancer patients with peripherally inserted central catheter（PICC）. Methods：Clinical data of 20 lung cancer patients with PICC were randomly select－ed in our department. Heparin sodium（125 U/ml） was used for locking after PICC being inserted. All parameters in our study includ－ing prothromhin time（PT），activated partial thromboplsatin time（APTT），thrombin time（TT），fibrinoge（Fbg），platelet（PLT） and D-dimer were dynamically monitored 2 times：0~1 d before（T0） and 2~3 d after（T1）PICC insertion. Results：Differences in PLT and D-dimer between T0 and T1 were significant（t=2.387，P=0.028；t=2.487，P=0.022）. There was no significant difference in PT，APTT，TT，Fbg，FDP between T1 and T0. Conclusions：①Using heparin sodium（125 U/ml） for locking is safe for patients with lung cancer after PICC insertion. ②Heparin sodium（125 U/ml） for locking can reduce PLT and D-dimer levels of patients with lung cancer after PICC insertion and can prevent venous thrombosis.