Objective: To explore the high risk factors of catheter-related thrombosis (CRT) in breast cancer patients, and provide the basis for the development of appropriate prevention and treatment strategies. Methods: A total of 1 432 breast cancer patients scheduled to receive central venous catheterization in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from January 1, 2015 to August 31, 2019 were selected. Baseline information and catheterization information of patients were collected. The occurrence of CRT was confirmed by vascular ultrasound examination, and the influencing factors of CRT were analyzed. Results: The total number of catheter days were 121, 980 days in 1 432 patients with breast cancer, and the average number of catheter days in each patient was 85.2 days. The incidence of CRT was 6.8% (97/1 432), which was 0.79 cases/1 000 catheter days. Among 815 patients with centrally inserted central venous catheters (CICC), 43 (5.3%) had CRT, which was 0.70 cases/1 000 catheter days. Among 617 patients with peripherally inserted central venous catheters (PICC), 54 (8.8%) developed CRT, which was 0.90 cases/1 000 catheter days. CRT was most common in subclavian vein (63.9%). Multivariate regression analysis showed that age ≥ 60 years old (OR=1.712, 95% CI: 1.056-2.775, P=0.029), PICC (OR=1.732, 95% CI: 1.130-2.656, P=0.012), the catheter position except subclavian vein (OR=10.420, 95% CI: 1.207-89.991), secondary adjustment of catheter position (OR=3.985, 95% CI: 1.510-10.521, P=0.005) and high D-Dimer level (OR=1.129, 95% CI: 1.026-1.241, P=0.012)were independent risk factors for CRT. Conclusions: The CRT problem can't be ignored in the clinical treatment of breast cancer patients with central venous catheterization. Screening the appropriate age of patients and the type of central venous catheters, reducing the secondary adjustment of catheter position, and timely monitoring the level of D-dimer are helpful to the prevention and treatment of CRT.
目的： 探讨乳腺癌患者导管相关性血栓(CRT)的高危因素，为制定合适的防治策略提供依据。 方法： 选择2015年1月1日至2019年8月31日在中国医学科学院肿瘤医院计划接受中心静脉置管的乳腺癌患者1 432例，收集患者的基线信息、导管使用信息，通过血管超声检查确认CRT的发生情况，分析CRT发生的影响因素。 结果： 1 432例乳腺癌患者总置管天数达121 980 d，每例患者的平均置管天数为85.2 d。CRT发生率为6.8%(97/1 432)，即0.79例/1 000置管日。815例CICC患者中，43例(5.3%)发生CRT，即0.70例/1 000置管日；617例PICC患者中，54例(8.8%)发生CRT，即0.90例/1 000置管日。CRT最常见于锁骨下静脉，占63.9%。多因素回归分析显示，患者年龄、中心静脉置管种类、导管尖端位置、二次调整导管位置、D-二聚体为CRT发生的独立影响因素，年龄≥60岁(OR＝1.712，95% CI为1.056～2.775)、采用PICC(OR＝1.732，95% CI为1.130～2.656)、导管尖端位置不在下腔静脉(OR＝10.420，95% CI为1.207～89.991)、二次调整导管位置(OR＝3.985, 95% CI为1.510～10.521)和高D-二聚体(OR＝1.129，95% CI为1.026～1.241)的患者发生CRT的风险较大。 结论： 乳腺癌患者采取中心静脉置管进行临床治疗的过程中发生CRT的问题不容忽视，选择年龄适宜的患者和中心静脉置管种类，置管位置准确，减少二次调整导管位置，及时监测D-二聚体水平有助于CRT的防治。.
Keywords: Breast neoplasms; Catheter-related thrombosis; Central venous catheter; Risk factor.