肺癌患者静脉血栓栓塞症的危险因素分析及预防现状  

Analysis of risk factors and prevention status of venousthromboembolism in patients with lung cancer

作　　者：黎苏 汪玲玲 霍虹[3] 祁英杰 刘广宣 LI Su;WANG Ling-ling;HUO Hong;QI Ying-jie;LIU Guang-xuan(Department of pharmacy,Cancer Hospital of China Medical University,Liaoning Cancer Hospital & Institute,Liaoning Shenyang 110042,China;School of Life Sciences and Biopharmaceutical,Shenyang Pharmaceutical University,Liaoning Shenyang 110016,China;Department of Pharmaceutics,School of Pharmacy,China Medical University,Liaoning Shenyang 110122,China)

机构地区：[1]中国医科大学肿瘤医院辽宁省肿瘤医院药学部,辽宁沈阳110042 [2]沈阳药科大学生命科学与生物制药学院,辽宁沈阳110016 [3]中国医科大学药学院药剂教研室,辽宁沈阳110122

出　　处：《中国医院药学杂志》2019年第13期1395-1400,共6页Chinese Journal of Hospital Pharmacy

摘　　要：目的:通过了解某院肺癌患者静脉血栓栓塞症(VTE)形成的相关危险因素和预防现状,以及抗凝药物的疗效分析和影响因素,以推动临床进行规范化的血栓预防。方法:收集该院2017年6月到2018年6月住院的肺癌患者的病历资料,回顾性分析与VTE相关的危险因素并进行评分,比较使用抗凝药物前后血细胞、凝血象以及肝肾功能的变化。采用SPSS 22.0软件进行数据处理。结果:患者的治疗方式、性别、吸烟史、饮酒史、病理分型、白细胞、中性粒细胞、血红蛋白与VTE的形成相关(P<0.05)。二元Logistic回归分析示:手术、有饮酒史、血红蛋白<100 g·L^-1是导致肺癌患者VTE的独立危险因素。部分患者在使用抗凝药物前后缺乏相应的检测指标。患者的饮酒史、病理分型、肝肾功能与抗凝药物的疗效有一定的相关性(P<0.05)。低分子肝素类抗凝药物的使用对患者的肝功能有一定的损害。结论:导致肺癌患者VTE的因素较多,临床对患者的凝血状态应提高重视。抗凝药物的使用应该更加规范,用药期间应监测患者肝功能。OBJECTIVE To understand the risk factors and prevention status of venous thromboembolism(VTE) in patients with lung cancer in a hospital, as well as the efficacy analysis of anticoagulants and influencing factors, so as to promote standardized thromboprophylaxis. METHODS The medical records of lung cancer patients hospitalized from June 2017 to June 2018 in this hospital were collected. The risk factors associated with VTE were retrospectively analyzed and scored. The changes of blood cell count, blood coagulation and liver and kidney function were compared before and after using anticoagulants. SPSS 22.0 software was used for data processing. RESULTS The treatment, gender, smoking history, drinking history, pathological type, WBC, neutrophil and hemoglobin were correlated with the formation of VTE(P<0.05). Binary Logistic regression analysis showed that surgery, history of alcohol consumption and hemoglobin less than 100 g·L^-1 were independent risk factors for VTE in lung cancer patients. Some patients lacked the corresponding test indicators before or after the use of anticoagulants. The history of alcohol consumption, pathological type, liver and kidney function were related to anticoagulation effect(P<0.05). The use of low molecular weight heparin anticoagulants was likely to bring about negative effects on the liver and kidney function of patients. CONCLUSION There are multiple factors leading to VTE in patients with lung cancer, and clinical attention should be paid to the coagulation state of patients. The use of clinical anticoagulants should be more standardized, and the liver function should be monitored during the medication.

关 键 词：肺癌 静脉血栓栓塞症(VTE) 危险因素 抗凝药物 

分 类 号：R927.2[医药卫生—药学]