恶性消化道肿瘤合并肺血栓栓塞25例临床分析

Clinical analysis of 25 cases of pulmonary thromboembolism complicated with malignant digestive tract tumor

目的 探讨恶性消化道肿瘤合并肺血栓栓塞的一般临床特点、危险因素、诊断、治疗及预后.方法 回顾性分析我院25例恶性消化道肿瘤合并肺血栓栓塞症患者（病例组）的临床资料,同时选择同期不伴恶性肿瘤的25例肺血栓栓塞患者作为对照组.结果 病例组与对照组相比,年龄、性别差异无统计学意义（P＞0.05）;在危险因素分析中,病例组和对照组相比,在近期制动史、下肢静脉曲张史、近期手术史差异有统计学意义（P＜0.05）,进一步行多因素logistic回归分析,有近期制动史、近期手术史者发生肺血栓栓塞明显增高（P＜0.05）;在实验室指标中,病例组与对照组相比,血小板计数及纤维蛋白原差异有统计学意义（P＜0.05）;经积极治疗后,病例组与对照组相比,病例组治疗效果差,病死率高.结论 恶性消化道肿瘤因手术制动及肿瘤本身因素,易发生肺血栓栓塞,恶性消化道肿瘤合并肺血栓栓塞患者治疗效果不佳,预后差.

Objective To investigate the general clinical features,risk factors,diagnosis,treatment and prognosis of malignant digestive tract tumor complicated with pulmonary embolism.Methods The clinical data of 25 cases of malignant digestive tumors complicated with pulmonary thromboembolism were retrospectively analyzed,and at the same period,25 cases of pulmonary embolism without malignant digestive tract tumor were selected as the control group.Results There was no significant difference in age or gender between case group and control group （P ＞ 0.05）.There were significant differences in history of recent surgery and history of varicose veins between case group and control group （P ＜ 0.05）.Further multivariate logistic regression analysis showed that,patients with the brake history and history of recent surgery had higher rate of pulmonary thromboembolism.There were significant differences in platelet count and fibrinogen between case group and control group （P ＜ 0.05）.After primary treatment,patient in case group had poorer treatment effect and high mortality rate.Concltsions Due to brake operation and tumor factors,malignant digestive tract tumors are prone to be complicated with pulmonary thrombosis,and the treatment effects are poor,the prognosis is bad.