目的 探讨胃癌胃大部切除术后颈内静脉导管留置相关性血栓形成的影响因素分析及护理探究.方法 选取2012年11月至2014年12月入我院进行胃癌根治术后留置颈内静脉导管患者112例,对患者拔除静脉导管后血凝块情况进行记录观察,分析术后颈内静脉导管留置相关性血栓形成的影响因素,讨论相关护理方式.结果 ①患者手术后留置相关性血栓形成的影响因素分析结果:患者年龄、日均用管时间、留置导管时间、手术后止血药应用与患者术后留置相关性血栓形成存在一定关系,差异具有统计学意义(P＜0.05);②患者术后留置相关性血栓形成的危险因素多元Cox回归分析结果得出:留置导管时间≥10h、无手术后止血药应用非影响患者手术后血栓形成的危险因素(P＞0.05);患者年龄≥30岁、日均用管时间≥15 h为影响患者手术后血栓形成的危险因素,差异具有统计学意义(P＜0.001).结论 对年龄较大或手术后日均用管时间较长的胃癌患者需进行针对性护理干预,减低手术后导管内血栓形成机率,提高患者术后疗效.%Objective To investigate the influencing factors and nursing observation of internal jugular vein catheter indwelling thrombogenesis after subtotal gastrectomy.Methods 112 cases with internal jugular vein catheter in our hospital from November 2012 to December 2014 were selected.Record the blood clot condition after removing of venous catheters,analyze influencing factors of internal jugular vein catheter indwelling thrombogenesis after subtotal gastrectomy and discuss nursing methods.Results ①) Influencing factors of corresponding thrombus showed that,age,average daily tube time,indwelling catheter time,postoperative hemostatics application had certain relation with corresponding thrombus,the difference was statistically significant (P ＜ 0.05);(②) Multivariate Cox regression analysis of corresponding thrombus showed that:indwelling tube time ≥ 10 h and no postoperative hemostatic application were risk factors that influence thrombogenesis after surgery (P ＞ 0.05);age ≥ 30,average daily tube time ≥ 15 h were risk factors that influence thrombogenesis after surgery (P ＜ 0.001).Conclusion Patients with older age and longer average daily tube time should given targeted nursing intervention,lower rate of thrombogenesis and improve postoperative effect of patients.
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