Analysis of the causes and countermeasures of deep vein thrombosis in the upper arm of elderly patients with PICC catheterization
老年PICC置管患者上臂深静脉血栓的原因分析与对策

摘要

目的 对老年PICC置管患者发生上臂深静脉血栓的原因进行分析，并探讨干预对策。方法 对老年PICC置管后深静脉血栓发生原因进行调查分析，选取2024年1月-2025年1月本院收治的100例行PICC置管的老年患者，随机分组，对照组50例行常规护理，观察组50例根据血栓发生原因行以循证为基础的针对性护理，对两组干预结果进行比较。结果 干预前，两组Caprini量表评分、置管总时间、上臂围各项临床指标比较，不具显著差异（P>0.05），干预后，观察组Caprini量表评分更低、置管总时间更长、上臂围更小（P<0.05）；干预前，两组PT、D-D比较，不具显著差异（P>0.05），干预后，观察组各凝血指标水平更低（P<0.05）；两组并发症发生率比较，观察组4.00%更低（P<0.05）。结论 明确老年PICC置管患者发生上臂深静脉血栓的原因可为临床构建科学合理的护理方案提供指导意见，通过实施以循证支持为基础的护理干预可帮助临床识别老年PICC置管患者DVT发生风险，并采取针对性干预措施，对降低DVT风险、延长置管时间、缩小上臂围有积极作用，还可改善患者凝血功能，减少血栓、静脉炎等并发症发生，具有较高应用价值。

Abstract

Objective To analyze the causes of deep vein thrombosis in the upper arm in elderly patients with PICC catheterization and explore the intervention strategies.
Methods The causes of deep vein thrombosis after PICC catheterization in the elderly were investigated and analyzed. A total of 100 elderly patients who underwent PICC catheterization and were admitted to our hospital from January 2024 to January 2025.1 were selected and randomly divided into groups. Fifty patients in the control group received routine care, and 50 patients in the observation group received targeted care based on evidence according to the causes of thrombosis. The intervention results of the two groups were compared.
Results Before the intervention, there was no significant difference in the clinical indicators of the Caprini scale score, total catheterization time, and upper arm circumference between the two groups (P>0.05). After the intervention, the Caprini scale score of the observation group was lower, the total catheterization time was longer, and the upper arm circumference was smaller (P<0.05). Before the intervention, there was no significant difference in PT and D-D between the two groups (P>0.05). After the intervention, the levels of each coagulation index in the observation group were lower (P<0.05). The comparison of the incidence of complications between the two groups showed that the observation group was 4.00% lower (P<0.05).
Conclusion   Clarifying the causes of upper arm deep vein thrombosis in elderly patients with PICC catheterization can provide guidance for the clinical construction of a scientific and reasonable nursing plan. Through the implementation of nursing intervention based on evidence-based support, it can help the clinical identification of the risk of DVT in elderly patients with PICC catheterization and take targeted intervention measures. It has a positive effect on reducing the risk of DVT, prolonging the catheterization time, and shrinking the upper arm circumference. It can also improve the coagulation function of patients and reduce the occurrence of complications such as thrombosis and phlebitis, and has high application value.