The high-risk factors and nursing of venous thrombosis caused by PICC catheter-related on patients with acute pancreatitis

Abstract

Objective To explore the high-risk factors of upper extremity venous thrombosis caused by PICC catheter on patients with acute pancreatitis, and sum up the nursing countermeasures. Methods A total of 368 cases of patients with acute pancreatitis gastroenterology indwelling PICC catheter from February 2015 to January 2016 in our hospital were selected.13 cases of patients with PICC-related venous thrombosis were studied retrospectively to analyze the age, gender, intravenous catheter, catheter body, disease severity, D-dimer (D-D), prothrombin time (PT), fibrinogen (FIB) value, and the relationship between APTT and the formation of thromboplastin venous thrombosis and the time for the formation of thrombosis. Results 13 patients were diagnosed as venous thrombosis, the differences of gender and age were not statistically significant(P>0.05). There was statistical significance in terms of the difference of thrombosis of mild and relatively severe pancreatitis patients(P<0.01). The highest rate of the formation of vein thrombosis was right cephalic (37.5%). The incidence of vein thrombosis caused by the left and right upper extremity median cubital was 12.0% and 4.7% respectively.The incidence of vein thrombosis caused by left right basilic vein thrombosis rates was 1.3% and 0.6% respectively.The PT of the patients with vein thrombosis was higher than that of the patients without vein thrombosis, and the difference was statistically significant(P<0.05). APTT, FIB , D-D of patients with thrombosis was significantly higher than that of the patients without vein thrombosis, and the difference was significant(P<0.01). The average time of the formation of thrombosis after indwelling PICC catheter was(12.6±7.8) days, thrombosis can occur as early as 3 to 4 days after the first catheter. Conclusions The formation of the venous thrombosis is directly affected by the blood coagulation and the changes of the fibrinolysis system of the patients with severe acute pancreatitis.Nurses should strengthen the awareness of prevention for PICC catheter-related venous thrombosis.The patients' coagulation indicator is strictly assessed of before the catheter.The appropriate intravenous catheter is selected during the catheter.The comprehensive nursing intervention is conducted after the catheter to reduce the incidence of PICC catheter-related venous thrombosis and prolong the catheterization time. Key words: Acute pancreatitis; PICC catheter; Venous thrombosis; Nursing Strategy