胸部恶性肿瘤术后发生静脉血栓栓塞的危险因素分析  

Analysis of risk factors for venous thromboembolism after surgery for thoracic malignant tumors

作　　者：吴艳[1] 张冬梅[2] 毕昭雪 孙清超[1] Wu Yan;Zhang Dongmei;Bi Zhaoxue;Sun Qingchao(Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;Respiratory and Critical Care Medical Center,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi 830001,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院胸外科,新疆乌鲁木齐830054 [2]新疆维吾尔自治区人民医院呼吸与危重症医学中心,新疆乌鲁木齐830001

出　　处：《血管与腔内血管外科杂志》2023年第12期1495-1499,共5页Journal of Vascular and Endovascular Surgery

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2020-SG3)。

摘　　要：目的探讨胸部恶性肿瘤患者术后住院期间发生静脉血栓栓塞(VTE)的危险因素。方法收集2020年2月至2023年2月新疆医科大学第一附属医院收治的132例胸部恶性肿瘤患者的临床资料,根据住院期间是否发生VTE将患者分为VTE组(n=31)和对照组(n=101)。比较两组患者的临床特征、手术相关信息及术后主要治疗情况。采用多因素Logistic回归模型分析胸部恶性肿瘤患者术后住院期间发生VTE的危险因素。结果VTE组患者的年龄、合并肺动脉高压的比例、术前C反应蛋白水平升高的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。VTE组患者术中低体温的发生率、术后住院期间呼吸机使用时间﹥3 d的比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥65岁、合并肺动脉高压、术前C反应蛋白水平升高、术中发生低体温以及术后住院期间呼吸机使用时间﹥3 d均是胸部恶性肿瘤患者术后住院期间发生VTE的独立危险因素(P﹤0.05)。结论年龄≥65岁、合并肺动脉高压、术前C反应蛋白水平升高、术中发生低体温以及术后住院期间呼吸机使用时间﹥3 d均会增加胸部恶性肿瘤患者术后住院期间发生VTE的风险,在临床实践中应对合并这些危险因素的患者进行严密监测和强化针对性预防。Objective To investigate the risk factors for venous thromboembolism(VTE)in patients with thoracic malignant tumors during postoperative hospitalization.Method The clinical data of 132 patients with thoracic malignant tumors admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2020 to February 2023 were collected.Patients were divided into VTE group(n=31)and control group(n=101)according to whether VTE occurred during hospitalization.The clinical characteristics,surgery-related information,and main postoperative treatments of the two groups of patients were compared.Multivariate Logistic regression model was used to analyze the risk factors for VTE during postoperative hospitalization in patients with thoracic malignant tumors.Result The age,the proportion of patients with pulmonary hypertension,and the proportion of elevated preoperative C-reactive protein levels of the patients in the VTE group were all higher than those of the patients in the control group,and the differences were statistically significant(P<0.05).The incidence of intraoperative hypothermia and the proportion of ventilator use time>3 d during postoperative hospitalization in the VTE group were higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate analysis results showed that age≥65 years old,pulmonary hypertension,elevated preoperative C-reactive protein levels,intraoperative hypothermia,and ventilator use time>3 d during postoperative hospitalization were all independent risk factors for VTE during postoperative hospitalization for patients with thoracic malignant tumors(P<0.05).Conclusion Age≥65 years old,pulmonary hypertension,elevated preoperative C-reactive protein levels,intraoperative hypothermia,and ventilator use time>3 d during postoperative hospitalization will increase the risk of VTE during postoperative hospitalization in patients with thoracic malignant tumors.Patients with these risk factors should be closely monitored and targeted pr

关 键 词：食管癌 肺癌 纵隔恶性肿瘤 静脉血栓栓塞 危险因素 

分 类 号：R543[医药卫生—心血管疾病]