子宫内膜癌症状性VTE发生危险因素临床分析  

A clinical analysis of symptomatic VTE risk factors for endometrial carcinoma

作　　者：夏伟[1,2] 李赫 王志启 王建六[1] Xia Wei;Li He;Wang Zhiqi(Gynecology and Obstetrics Department,Peking University People's Hospital,Beijing 100044;Gynecology and Obstetrics Department,Peking University International Hospital,Beijing 102206)

机构地区：[1]北京大学人民医院妇产科,北京100044 [2]北京大学国际医院妇产科,北京102206

出　　处：《现代妇产科进展》2021年第1期1-4,共4页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金面上项目(No:81972426);国家科技支撑计划(No:2019YFC1005200,2019YFC1005201)。

摘　　要：目的:分析子宫内膜癌患者发生静脉血栓栓塞的危险因素。方法:回顾分析2004年1月至2012年12月于北京大学人民医院妇科初治接受手术治疗并具有完整随访资料的子宫内膜癌患者496例,其中有症状的静脉血栓栓塞患者23例(血栓组),其他473例为对照组。结果:血栓组中具有下肢静脉血栓病史患者比例高于对照组(8.7%vs 0.2%,P=0.006),血栓组的平均手术时间长于对照组[(3.7±1.1)h vs(3.0±1.0)h,P=0.002],血栓组术后合并淋巴囊肿的患者比例高于对照组(17.4%vs 2.3%,P=0.003),术后肠梗阻的比例高于对照组(13.0%vs 1.9%,P=0.015),血栓组中Ⅲ/Ⅳ患者的比例高于对照组(43.5%vs 14.0%,P<0.001)。多因素分析提示,下肢深静脉血栓病史、术后淋巴囊肿、术后肠梗阻、肿瘤晚期(FIGO Ⅲ/Ⅳ期)等是内膜癌患者静脉血栓栓塞发生的独立危险因素(OR=55.306,P=0.002;OR=5.792,P=0.014;OR=5.055,P=0.050;OR=3.676,P=0.007)。结论:既往有下肢深静脉血栓病史、术后肠梗阻、术后淋巴囊肿、肿瘤晚期是子宫内膜癌患者VTE发生的独立危险因素。Objective:To analyze the risk factors of venous thromboembolism in patients with endometrial cancer.Methods:496 cases of endometrial cancer patients who underwent surgical treatment and completed follow-up data in Peking University People's Hospital between January 2004 and December 2012 were retrospectively analyzed.Twenty-three patients with symptomatic venous thromboembolism were the thrombosis group,and the other 473 cases were the control group.Results:The proportion of patients with a history of lower extremity venous thrombosis in the thrombosis group was higher than that in the control group(8.7%vs 0.2%,P=0.006).The average operation time in the thrombosis group was longer than that in the control group[(3.7±1.1)h vs(3.0±1.0)h,P=0.002].The proportion of patients with lymph cysts in the thrombosis group after surgery was higher than that in the control group(17.4%vs 2.3%,P=0.003).And the proportion of postoperative intestinal obstruction was higher than that in the control group(13.0%vs 1.9%,P=0.015).The proportion of stage Ⅲ/Ⅳ patients in the thrombosis group was higher than that in the control group(43.5%vs 14.0%,P<0.001).Multivariate analysis suggested that the history of deep vein thrombosis of lower extremities,postoperative lymphatic cysts,postoperative intestinal obstruction,and advanced tumors(FIGO Ⅲ/Ⅳ)were independent risk factors for venous thromboembolism in patients with endometrial cancer(OR=55.306,P=0.002,OR=5.792,P=0.014,OR=5.055,P=0.050,OR=3.676,P=0.007).Conclusion:The previous history of deep vein thrombosis of lower extremities,postoperative intestinal obstruction,postoperative lymphatic cyst,and advanced tumor are independent risk factors for the occurrence of VTE in patients with endometrial cancer.

关 键 词：子宫内膜癌 静脉血栓栓塞 危险因素 

分 类 号：R737.33[医药卫生—肿瘤]