结直肠癌根治术后并发静脉血栓栓塞的相关危险因素分析

Risk Factors of Venous Thromboembolism after Radical Resection of Colorectal Cancer

目的:研究结直肠癌根治术后发生静脉血栓栓塞(venous thromboembolism,VTE)的相关危险因素,以期指导预防和治疗。方法:选取2017年1月1日至2018年12月31日在四川省肿瘤医院行结直肠癌根治术后发生VTE的患者16例、同期未发生VTE的患者198例,采用单因素和多因素Logistic回归分析结直肠癌根治术后并发静脉血栓栓塞的相关危险因素。结果:经单因素分析,非VTE组和VTE组患者在年龄、既往VTE病史、2型糖尿病史、心血管疾病史、高脂血症史、手术时间、感染、术后制动时间、静脉穿刺次数上差异有统计学意义(P<0.05);而在性别、是否吸烟、是否嗜酒、BMI、是否合并呼吸系统疾病、术前是否放化疗、AJCC分期、肿瘤部位、术中出血、是否输血上差异无统计学意义。将单因素整理出的相关危险因素进行赋值后行多因素Logistic回归分析得出年龄、既往VTE病史、2型糖尿病、心血管疾病、高脂血症、手术时间、感染、术后制动时间、静脉穿刺次数与结直肠癌根治术后并发静脉血栓栓塞有回归关系。结论:结直肠癌术后易并发静脉血栓栓塞,对于年龄较大、既往有VTE病史同时合并基础内科疾病的患者术中应尽量缩短手术时间,术后注意预防感染、加强活动、降低静脉穿刺次数,预防术后静脉血栓栓塞的形成。

Objective:To study the risk factors of venous thromboembolism(VTE)after radical resection of colorectal cancer,so as to guide the prevention and treatment of VTE.Methods:16 patients with VTE and 198 patients without VTE who underwent radical resection of colorectal cancer in Sichuan cancer hospital from January 1,2017 to December31,2018 were selected.Risk factors of VTE after colorectal cancer resection were analyzed by univariate and multivariate logistic regression analyses.Results:Univariate logistic regression analysis revealed that differences between the non-VTE group and the VTE group were significant in age,history of VTE,history of type 2 diabetes,history of cardiovascular diseases,history of hyperlipidemia,operation time,infection,postoperative immobilization time and number of venipuncture attempts(P<0.05);and were not significant in sex,tobacco use,alcohol use,BMI,respiratory diseases(comorbidity),preoperative radiotherapy and chemotherapy,AJCC stage,site of tumor,intraoperative bleeding and blood transfusion.Multivariate logistic regression analysis showed that age,history of VTE,history of type 2 diabetes,history of cardiovascular diseases,history of hyperlipidemia,operation time,infection,postoperative immobilization time,number of venipuncture attempts were correlated to postoperative VTE in colorectal cancer patients.Conclusion:VTE is an easily occurred complication in colorectal cancer patients after surgery.For elder patients with VTE history and internal medical diseases,the operation time should be reduced as much as possible.After surgery,attention should be paid to prevent infection,encourage mild activities and reduce the number of venipuncture attempts,so as to prevent VTE.