乳腺癌患者术后下肢深静脉血栓发生的危险因素分析

Risk factor analysis of deep venous thrombosis of the lower extremity in patients with breast cancer after surgery

目的探讨乳腺癌患者术后下肢深静脉血栓(DVT)发生的危险因素。方法回顾性分析山西省肿瘤医院2016年5月至2019年5月收治的95例乳腺癌术后发生下肢DVT的女性患者(试验组),以2019年1月至5月诊治的85例乳腺癌术后未发生下肢DVT的女性患者作为对照组。比较两组患者的一般资料及血浆总胆固醇(TC)、三酰甘油(TG)、D-二聚体(D-D)水平,探讨影响乳腺癌术后患者发生下肢DVT的危险因素。结果试验组体质量[(69.05±6.49)kg比(61.75±6.62)kg]、体质量指数(BMI)[(29.89±1.78)kg/m2比(24.23±1.33)kg/m2]及年龄[(51.57±5.93)岁比(45.44±5.21)岁]均大于对照组,差异均有统计学意义(均P<0.01)。试验组TC水平略高于对照组,差异无统计学意义(P>0.05);试验组TG水平高于对照组,差异有统计学意义(P<0.01);试验组术后10 d的D-D水平高于对照组,差异有统计学意义(P<0.01)。logistic回归分析显示,体质量>66.25 kg(OR=1.507,95%CI 1.101~2.122,P=0.021)、BMI>25.43 kg/m2(OR=1.518,95%CI 1.067~2.123,P=0.017)、TG≥1.8 mmol/L(OR=1.324,95%CI 1.077~2.139,P=0.045)、术后D-D>5.0 mg/L(OR=1.525,95%CI 1.110~2.231,P=0.027)、手术时长≥2 h(OR=1.470,95%CI 1.017~2.122,P=0.033)是乳腺癌患者发生DVT的独立影响因素。结论乳腺癌患者术后易发生下肢DVT,对于体质量大、BMI高、血脂高、D-D高及手术时长≥2 h的患者,术后应提早预防,一旦出现下肢肿胀的状况,应及早治疗。

Objective To explore the risk factors of deep vein thrombosis(DVT)of the lower extremity in patients with breast cancer after surgery.Methods A total of 95 female patients(the experimental group)with DVT of the lower extremity after breast cancer surgery in Shanxi Provincial Cancer Hospital from May 2016 to May 2019 were retrospectively analyzed,and 85 female breast cancer patients without DVT of the lower extremity after surgery from January 2019 to May 2019 were treated as the control group.The general information and plasma total cholesterol(TC),triglyceride(TG),D-dimer(D-D)levels were compared between the two groups,and the risk factors for DVT of the lower extremity in patients with breast cancer after surgery were explored.Results The body weight[(69.05±6.49)kg vs.(61.75±6.62)kg],body mass index(BMI)[(29.89±1.78)kg/m2 vs.(24.23±1.33)kg/m2]and the age[(51.57±5.93)years old vs.(45.44±5.21)years old]in the experimental group were higher than those in the control group,and the differences were statistically significant(all P<0.01).The TC level in the experimental group was slightly higher than that in the control group,and the difference was not statistically significant(P>0.05);the TG level in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.01);the D-D level of the experimental group at 10 d after operation was higher than that of the control group,and the difference was statistically significant(P<0.01).Logistic regression analysis showed that body weight>66.25 kg(OR=1.507,95%CI 1.101-2.122,P=0.021),BMI>25.43 kg/m2(OR=1.518,95%CI 1.067-2.123,P=0.017),TG≥1.8 mmol/L(OR=1.324,95%CI 1.077-2.139,P=0.045),postoperative D-D>5.0 mg/L(OR=1.525,95%CI1.110-2.231,P=0.027),and surgery duration≥2 h(OR=1.470,95%CI 1.017-2.122,P=0.033)were independent influencing factors of DVT in breast cancer patients.Conclusions Breast cancer patients are prone to DVT of the lower extremity after operation.For patients with large body weight,high BMI,high blood lipids,high D-D and the operation duration≥2 h,the postoperative prevention for DVT should be carried out early.Once there is a condition of lower extremity swelling,early treatment should be given.