恶性血液肿瘤并发静脉血栓栓塞症相关危险因素的临床分析

Clinical Analysis of the risk Factors of Hematologic Malignancies Complicated with Venous Thromboembolism

目的探讨恶性血液肿瘤并发静脉血栓栓症的相关临床危险因素,以提高临床医师对该并发症的认识。方法收集我院35例恶性血液肿瘤合并静脉血栓栓塞症患者为病例组,以同期41例恶性血液肿瘤非静脉血栓栓塞症患者为对照组,回顾性分析可能存在危险因素;结果静脉血栓多发生在恶性血液肿瘤确诊的3个月内,以淋巴瘤和急性白血病较为多见,发生部位以左下肢最为常见;单因素分析结果显示病例组与对照组在化疗前白细胞计数>11×109/L、D-dimer>500 ng/mL、中心静脉置管、激素、感染、粒细胞集落刺激因子和卧床时间>7 d存在显著性差异(P<0.05);多因素logistic回归分析结果显示化疗前白细胞计数>11×109/L、D-dimer>500 ng/mL、中心静脉置管和卧床时间>7 d为恶性血液肿瘤合并静脉血栓栓塞症的独立危险因素。结论对于化疗前白细胞计数>11×109/L、D-dimer>500 ng/mL、有中心静脉置管及卧床时间>7 d的恶性血液肿瘤患者,容易发生静脉血栓栓塞症,临床医师应予以高度重视,早期发现及时治疗,以减轻患者痛苦及经济损失。

Objective To explore the risk factors of hematologic malignancies complicated with venous thromboembolism,in order to improve clinican＇ s understanding of this complication. Methods We col- lected the clinical data of 35 patients with hematologic malignancies complicated with venous thromboembolism as the case group,and 41 patients with hematologic malignancies of non-venous thromboembolism as the control group at the same time,The datas were retrospective analysed. Results Venous thrombosis happened in the first three months of hematological malignancies diagnosis, lymphoma and acute lekemia were common,the most common location was the left lower limb;Single factors analysis results were showed that there were significant difference between control and case group in central venous catheter,granulocyte colony stimulating factor,hormone,lying in bed 〉 7 days,infection ,white blood cell counts 〉 11 × 109/L and D-dimer 〉 500 ng/ ml before cheotherapy （P 〈 0.05 ） ;Binary Logistic regression analysis showed that central venous catheter,lying in bed 〉 7 days,white blood cell counts 〉 11 × 109/L and D-dimer 〉 500 ng/ml before cheotherapy were independent risk factors of hematologic malignancies complicated with venous thromboembolism. Conclusion hematologic malignancies with central venous catheter,lying in bed 〉 7 days,white blood cell 〉 11 × 109/L and Ddimer 〉 500 ng/ml before cheotherapy are prone to complicate venous thromboembolism. Clinicians shoud be more pay attention to this complication, detect early and treat timely. It should be reduce the economic loss and patient＇ s pain to improve of the quality of life.