集束化干预措施下颅脑肿瘤术后肺血栓栓塞症严重程度危险因素分析  

Analysis of risk factors for severity of pulmonary thromboembolism after craniocerebral tumor operation under cluster intervention measure

作　　者：杨亚坤[1] 韩松[1] 刘宁[1] 张旭妃[2] 张林朋 韩明阳 张云馨 闫长祥[1] YANG Yakun;HAN Song;LIU Ning;ZHANG Xufei;ZHANG Linpeng;HAN Mingyang;ZHANG Yunxin;YAN Changxiang(Department of Neurosurgery,Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China;Department of Neurological Imaging,Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China;Department of Neurological Intensive Care Unit,Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China)

机构地区：[1]首都医科大学三博脑科医院神经外科,北京100093 [2]首都医科大学三博脑科医院神经影像科,北京100093 [3]首都医科大学三博脑科医院神经重症科,北京100093

出　　处：《中国医药导报》2021年第14期76-80,共5页China Medical Herald

基　　金：北京市博士后科研活动经费资助项目(ZZ2019-03)。

摘　　要：目的分析集束化干预措施下颅脑肿瘤术后不同严重程度肺血栓栓塞症的危险因素,为临床早期干预肺血栓栓塞症提供参考。方法回顾性分析2016年6月—2019年6月首都医科大学三博脑科医院神经外科收治的56例颅脑肿瘤术后经CT肺血管造影确诊的肺血栓栓塞症患者的临床信息。依据肺血栓栓塞诊疗指南将患者分为低危组(36例)和高危组(20例)。比较两组临床表型、凝血功能及围术期相关因素,采用多因素logistic回归分析发生不同严重程度肺血栓栓塞症的危险因素。结果56例患者中男35例,女21例;平均年龄(46.23±18.12)岁。术后病理结果显示恶性肿瘤20例,占比35.71%;良性肿瘤36例,占64.29%。肿瘤发生部位分类显示鞍区肿瘤26例,占46.43%;幕上肿瘤21例,占37.50%;颅底肿瘤7例,占12.5%;幕下肿瘤2例,占3.57%。两组临床表型与凝血功能比较,差异无统计学意义(P>0.05)。除术前禁食水时间外,两组围术期相关因素比较,差异无统计学意义(P>0.05)。logistic多因素回归分析结果显示存在术后肢体活动障碍是颅脑肿瘤术后肺血栓栓塞症危险因素(OR=9.574,P=0.02)。结论颅脑肿瘤术后肺血栓栓塞症基础病因复杂,临床表现无特异性;肺血栓栓塞症危险因素的识别联合实验室检查结果,有助于肺血栓栓塞症的早期诊治。Objective To analyze the risk factors of pulmonary thromboembolism with different severity after craniocerebral tumor operation under cluster intervention measures,and to provide reference for early clinical intervention of pulmonary thromboembolism.Methods The clinical information of 56 patients with pulmonary thromboembolism diagnosed by CT pulmonary angiography after craniocerebral tumor operation in the Department of Neurosurgery,Sanbo Brain Hospital,Capital Medical University from June 2016 to June 2019 was retrospectively analyzed.The patients were divided into low risk group(36 cases)and high risk group(20 cases)according to the diagnosis and treatment guidelines of pulmonary thromboembolism.Clinical phenotypes,coagulation function and perioperative related factors were compared between the two groups,and multivariate logistic regression was used to analyze the risk factors of pulmonary thromboembolism with different severity.Results Among the 56 patients,35 were male and 21 were female.The mean age was(46.23±18.12)years old.Postoperative pathology showed malignant tumor in 20 cases,accounting for 35.71%;benign tumors in 36 cases,accounting for 64.29%.Tumor site classification showed sellar region tumors in 26 cases,accounting for 46.43%;supratentorial tumor in 21 cases,accounting for 37.50%;skull base tumor in 7 cases,accounting for 12.5%;infratentorial tumor in 2 cases,accounting for 3.57%.There were no significant differences in clinical phenotype and coagulation function between the two groups(P>0.05).There was no significant difference in perioperative related factors between the two groups except the time of water fasting before operation(P>0.05).Multivariate logistic regression analysis showed that the presence of postoperative limb mobility disorder was a risk factor for pulmonary thromboembolism after craniocerebral tumor operation(OR=9.574,P=0.02).Conclusion Pulmonary thromboembolism after craniocerebral tumor operation has complex underlying causes and no specific clinical manifestations.The id

关 键 词：颅脑肿瘤 肺血栓栓塞症 临床特点 危险因素 

分 类 号：R563.5[医药卫生—呼吸系统]