妇科肿瘤术后肺动脉栓塞的危险因素分析

Risk Factors of Acute Pulmonary Embolism in Perioperative Patients with Gynecologic Tumors

目的:探讨妇科肿瘤术后发生急性肺动脉栓塞的危险因素。方法:回顾性分析福建省肿瘤医院2014年8月-2019年8月共97例妇科肿瘤术后行肺动脉CTA检查患者的临床资料,对比肺栓塞组及未栓塞组各项指标的差别,并将有差异性的指标进行二元Logistic回归分析,从而判断妇科肿瘤术后肺动脉栓塞的危险因素。结果:本组资料显示97例妇科肿瘤并行手术治疗的患者中,发生肺栓塞共43例。经单因素分析显示,年龄增大、BMI升高、术前总胆固醇及低密度脂蛋白值升高、术后当天补液量少、术后补充晶体液量少、术后D-二聚体值升高10倍以上、术后肺部感染与妇科肿瘤术后发生肺动脉栓塞存在相关性,差异均有统计学意义(P<0.05)。二元Logistic回归分析显示,BMI升高、术后肺部感染是妇科肿瘤术后发生急性肺动脉栓塞的独立危险因素,差异均有统计学意义(P<0.05)。结论:妇科肿瘤并行手术治疗的患者,合并BMI升高、术后肺部感染者发生肺栓塞的危险性更高。

Objective:To explore the risk factors of acute pulmonary embolism in postoperative patients with gynecologic tumors surgery.Method:The clinical data of 97 patients who underwent pulmonary artery CTA examination after gynecologic tumors surgery from August 2014 to August 2019 in our hospital were retrospectively analyzed.The difference of each index between the pulmonary embolism group and the non-embolism group was compared,and the binary Logistic regression analysis was carried out to judge the risk factors of pulmonary embolism after gynecological tumor operation.Result:The data showed that there were 43 cases of pulmonary embolism in 97 patients with gynecological tumor.The univariate analysis showed that age increase,BMI elevation,Pre-operative total cholesterol and low density lipoprotein values increased,the decrease of the amount of fluid replacement on the day after operation,the decrease of the volume of the supplementary crystals after operation,up to 10-fold increase in post-op D-dimer value,postoperative pulmonary infection were related to the occurrence of pulmonary embolism after the operation of gynecological tumors,the differences were statistically significant(P<0.05).Binary Logistic regression analysis showed that the increase of BMI and postoperative pulmonary infection were independent risk factors for acute pulmonary embolism after gynecological tumor operation,the differences were statistically significant(P<0.05).Conclusion:With the complications of higher BMI and postoperative pulmonary infection,postoperative patients with gynecologic tumors can suffer higher risk of pulmonary embolism.