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已发表论文
一项关于癌症患者经外周置入中心静脉导管（PICC）相关血栓风险分层护理干预预防效果的准实验研究
Authors Sun CJ, Ma L, Wang SY, Xue QY
Received 13 February 2025
Accepted for publication 22 May 2025
Published 24 September 2025 Volume 2025:18 Pages 3209—3220
DOI https://doi.org/10.2147/RMHP.S521571
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Jongwha Chang
Chun-Jie Sun,* Li Ma,* Su-Yun Wang, Qiu-Yun Xue
Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chun-Jie Sun, Email ftx233@yeah.net
Objective: To analyze risk factors for PICC-related thrombosis in cancer patients and assess the preventive efficacy of a risk-stratified nursing intervention based on these factors.
Methods: This prospective observational cohort study evaluated the preventive effect of risk-stratified nursing on PICC-related thrombosis in cancer patients. Chemotherapy patients undergoing PICC placement in the oncology department of our hospital from January 2023 to December 2024 were enrolled. Participants were allocated into two cohorts based on the implementation timeline of the nursing protocol: Control group (n=117) received routine PICC care (January 2023–December 2023), while intervention group (n=119) received risk-stratified nursing interventions (January 2024–December 2024) guided by a logistic regression model identifying key thrombosis risk factors (eg, tumor staging, comorbid diabetes, D-dimer levels).
Results: The intervention group (2024) exhibited a significantly lower PICC-related thrombosis incidence compared to the control group (2023) (4.20% vs 29.91%, χ²=28.436, P< 0.001). Multivariate analysis identified tumor stage III/IV (OR=2.556, 95% CI 1.798– 5.564), history of thrombosis (OR=19.273, 95% CI 10.674– 37.561), diabetes (OR=2.572, 95% CI 1.027– 5.712), catheter tip malposition (OR=14.339, 95% CI 8.916– 29.795), and elevated D-Dimer (OR=9.528, 95% CI 6.703– 15.597) as independent risk factors, while anticoagulant use (OR=0.449, 95% CI 0.089– 0.874) was protective. In the intervention cohort, protocol-guided anticoagulation showed enhanced protection (OR=0.332, 95% CI 0.121– 0.898, P=0.028). The intervention group also demonstrated improved quality of life across all SF-36 domains (eg, physical functioning: 58.94± 1.97 vs 45.93± 3.02, P< 0.05) and significantly higher nursing satisfaction (96.64% vs 86.32%, χ²=8.091, P=0.004).
Conclusion: Risk-stratified nursing interventions, guided by logistic regression analysis of thrombosis risk factors, significantly reduce PICC-related thrombosis incidence and improve patient quality of life and nursing satisfaction. This protocol offers a practical framework for oncology nursing to enhance patient outcomes.
Keywords: PICC catheter, thrombosis formation, influencing factors, risk-stratified nursing, oncology, application effect
Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chun-Jie Sun, Email ftx233@yeah.net
Objective: To analyze risk factors for PICC-related thrombosis in cancer patients and assess the preventive efficacy of a risk-stratified nursing intervention based on these factors.
Methods: This prospective observational cohort study evaluated the preventive effect of risk-stratified nursing on PICC-related thrombosis in cancer patients. Chemotherapy patients undergoing PICC placement in the oncology department of our hospital from January 2023 to December 2024 were enrolled. Participants were allocated into two cohorts based on the implementation timeline of the nursing protocol: Control group (n=117) received routine PICC care (January 2023–December 2023), while intervention group (n=119) received risk-stratified nursing interventions (January 2024–December 2024) guided by a logistic regression model identifying key thrombosis risk factors (eg, tumor staging, comorbid diabetes, D-dimer levels).
Results: The intervention group (2024) exhibited a significantly lower PICC-related thrombosis incidence compared to the control group (2023) (4.20% vs 29.91%, χ²=28.436, P< 0.001). Multivariate analysis identified tumor stage III/IV (OR=2.556, 95% CI 1.798– 5.564), history of thrombosis (OR=19.273, 95% CI 10.674– 37.561), diabetes (OR=2.572, 95% CI 1.027– 5.712), catheter tip malposition (OR=14.339, 95% CI 8.916– 29.795), and elevated D-Dimer (OR=9.528, 95% CI 6.703– 15.597) as independent risk factors, while anticoagulant use (OR=0.449, 95% CI 0.089– 0.874) was protective. In the intervention cohort, protocol-guided anticoagulation showed enhanced protection (OR=0.332, 95% CI 0.121– 0.898, P=0.028). The intervention group also demonstrated improved quality of life across all SF-36 domains (eg, physical functioning: 58.94± 1.97 vs 45.93± 3.02, P< 0.05) and significantly higher nursing satisfaction (96.64% vs 86.32%, χ²=8.091, P=0.004).
Conclusion: Risk-stratified nursing interventions, guided by logistic regression analysis of thrombosis risk factors, significantly reduce PICC-related thrombosis incidence and improve patient quality of life and nursing satisfaction. This protocol offers a practical framework for oncology nursing to enhance patient outcomes.
Keywords: PICC catheter, thrombosis formation, influencing factors, risk-stratified nursing, oncology, application effect