COPD合并肺癌患者术后深静脉血栓形成相关危险因素分析

Study on the related factors of postoperative deep vein thrombosis in COPD patients complicated with lung cancer

目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)合并肺癌患者术后深静脉血栓形成的相关危险因素。方法选取2016年1月至2017年1月本院收治的96例COPD合并肺癌患者为研究对象。所有患者入院后完善各项检查,采用肺癌根治术治疗,记录患者术后1个月内深静脉血栓形成情况,针对出现深静脉血栓的患者积极进行抗凝、溶栓治疗。对患者年龄、性别、体质指数(body mass index,BMI)、吸烟史、手术时间、卧床时间、下肢不对称肿胀、病理分型、COPD全球创议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级、血清甘油三酯(triglycerides,TG)水平、血小板计数、D-二聚体水平、白细胞计数、心血管病病史、静脉曲张病史等可能影响深静脉血栓形成的因素进行单因素及多因素Logistic回归分析。结果 96例患者中,共有17例患者出现深静脉血栓,发生率为17.7%。单因素及多因素Logistic回归分析显示,卧床时间≥5天、下肢不对称肿胀≥1 cm、GOLD分级3~4级、TG水平≥1.7 mmol/L、D-二聚体水平≥500μg/L均为COPD合并肺癌患者术后深静脉血栓形成的独立危险因素(P<0.05)。结论 COPD合并肺癌患者术后深静脉血栓形成的危险因素多种多样,临床上应积极采取预防措施,以降低患者术后血栓形成率和死亡风险,改善患者预后。

Objective To investigate the risk factors related to postoperative deep venous thrombosis in chronic obstructive pulmonary disease(COPD)patients complicated with lung cancer.Method From January 2016 and January 2017,96 patients with COPD complicated with lung cancer treated in our hospital were selected for study.All the patients were completed the examination and treated with radical resection of lung cancer,the incidence of deep vein thrombosis within 1 month after operation was recorded,and the patients with deep vein thrombosis were treated with anticoagulation and thrombolytic therapy.On the age of patients,sex,body mass index(BMI),smoking history,operation time,bed time,lower limb swelling,asymmetric pathological type,Global Initiative for Chronic Obstructive Lung Disease(GOLD)grade,serum triglyceride(TG)levels,platelet counts,D-dimer levels,white blood cell counts,cardiovascular disease history,medical history and other factors that may affect varices in patients with deep venous thrombosis were analyzed by univariate and multivariate Logistic regression.Result Deep venous thrombosis occurred in 17 of 96 patients,with a rate of 17.7%.After single-factor and multi-factor Logistic regression analysis,the time of lying in bed≥5 days,asymmetric swelling of the lower extremity≥1 cm,GOLD grade 3~4,TG levels≥1.7 mmol/L,and D-dimer levels≥500μg/L were the independent risk factors for postoperative deep venous thrombosis in patients with COPD combined with lung cancer(P<0.05).Conclusion There are various risk factors for postoperative deep venous thrombosis in patients with COPD combined with lung cancer.Preventive measures should be taken actively to reduce thrombosis and mortality,and improve prognosis.