新生儿PICC相关静脉血栓形成的危险因素分析

Analysis of Risk Factors for PICC-Related Venous Thrombosis in Neonates

摘要: 目的：探讨新生儿经外周置入中心静脉导管(peripherally inserted central catheter, PICC)相关静脉血栓形成的危险因素，为临床预防新生儿PICC相关静脉血栓形成提供循证学依据。方法：回顾性分析2023年05月01日至2025年07月31日青岛大学附属医院儿童医学中心新生儿科收治的PICC置管新生儿，按照出生时胎龄和出生体重1:10配对，分为血栓组与对照组。收集孕母、新生儿及PICC情况的相关资料。采用单因素及多因素logistic回归分析识别PICC相关静脉血栓形成的危险因素。结果：2023年05月01日至2025年07月31日期间共有PICC置管新生儿216例，其中血栓患儿4例，无血栓患儿212例。按出生时胎龄和出生体重1:10配对后，血栓组4例，对照组40例纳入研究。血栓组孕母自身免疫性疾病发生率(75% vs 7.5%)、置管后静脉液体糖浓度(18.50% ± 3.37% vs 9.93% ± 1.72%)高于对照组(P < 0.05)。其余孕母、新生儿及PICC情况无统计学差异。单因素logistic回归分析结果显示，孕母自身免疫性疾病(OR = 37.00, 95% CI: 2.89~474.21)、置管后静脉液体糖浓度(OR = 2.30, 95% CI: 1.12~4.75)是PICC相关静脉血栓形成的重要危险因素(P < 0.05)。多因素logistic回归分析显示置管后静脉液体糖浓度(OR = 2.14, 95% CI: 1.01~4.55)是PICC相关静脉血栓形成的危险因素(P < 0.05)。结论：孕母自身免疫性疾病、置管后静脉液体糖浓度有可能增加PICC相关静脉血栓形成的风险，而置管后静脉液体糖浓度是新生儿发生PICC相关静脉血栓形成的独立危险因素。

Abstract: Objective: To explore the risk factors for peripherally inserted central catheter (PICC)-related venous thrombosis in neonates, and to provide evidence-based basis for clinical prevention of PICC-related venous thrombosis in neonates. Methods: A retrospective analysis was conducted on neonates who underwent PICC catheterization and were admitted to the Neonatology Department of the Children’s Medical Center, Affiliated Hospital of Qingdao University, from May 1, 2023, to July 31, 2025. These neonates were paired at a 1:10 ratio based on gestational age at birth and birth weight, and divided into a thrombosis group and a control group. Relevant data regarding the pregnant mothers, neonates, and PICC conditions were collected. Univariate and multivariate logistic regression analyses were used to identify the risk factors for PICC-related venous thrombosis. Results: A From May 1, 2023, to July 31, 2025, a total of 216 neonates with PICC catheterization were included, among whom 4 had thrombosis and 212 had no thrombosis. After 1:10 matching based on gestational age at birth and birth weight, 4 neonates in the thrombus group and 40 in the control group were enrolled in the study. The incidence of maternal autoimmune diseases (75% vs 7.5%) and the glucose concentration of intravenous fluids after catheterization (18.50% ± 3.37% vs 9.93% ± 1.72%) in the thrombus group were significantly higher than those in the control group (P < 0.05). No statistically significant differences were observed in other characteristics of pregnant mothers, neonates, and PICC-related conditions between the two groups. Results of univariate logistic regression analysis showed that maternal autoimmune diseases (OR = 37.00, 95% CI: 2.89~474.21) and glucose concentration of intravenous fluids after catheterization (OR = 2.30, 95% CI: 1.12~4.75) were important risk factors for PICC-related venous thrombosis (P < 0.05). Multivariate logistic regression analysis indicated that the glucose concentration of intravenous fluids after catheterization (OR = 2.14, 95% CI: 1.01~4.55) was a risk factor for PICC-related venous thrombosis (P < 0.05). Conclusion: Maternal autoimmune diseases and the glucose concentration of intravenous fluids after catheterization may increase the risk of PICC-related venous thrombosis, while the glucose concentration of intravenous fluids after catheterization is an independent risk factor for PICC-related venous thrombosis in neonates.