胸腔镜肺癌切除术后下肢深静脉血栓形成的危险因素分析

High-risk factors affecting lower limb deep venous thrombosis after thoracoscopic lung cancer resection

目的探讨胸腔镜肺癌切除术后下肢深静脉血栓形成(DVT)的危险因素。方法选取首都医科大学附属北京天坛医院收治222例行胸腔镜肺癌切除术患者的临床资料,根据术后下肢DVT发生情况分为DVT组(n=74)和对照组(n=148)。胸腔镜肺癌切除术后发生下肢DVT的影响因素采用Logistic回归分析。结果术后,DVT组患者的纤维蛋白原(Fib)水平高于对照组患者,差异有统计学意义(P<0.05);术前D-二聚体>0.74 mg/L、术前Fib>3.46 g/L、术后Fib>3.54 g/L、术后卧床时间>72 h、术前化疗是胸腔镜肺癌切除术后发生下肢DVT的独立危险因素(P<0.05)。结论术前D-二聚体和Fib升高、术后Fib升高、卧床时间延长、术前化疗是胸腔镜肺癌切除后发生下肢DVT的独立危险因素,应该根据相关因素进行针对性监测及干预,降低下肢DVT的风险。

Objective To explore the risk factors of deep venous thrombosis(DVT)of lower limbs after thoracoscopic lung cancer resection.Method The clinical data of 222 patients undergoing thoracoscopic lung cancer resection in Beijing Tiantan Hospital,Capital Medical University were selected and divided into DVT group(n=74)and control group(n=148)according to postoperative occurrence of DVT of lower limbs.Logistic regression was used to analyze the influencing factors of lower extremity DVT after thoracoscopic lung cancer resection.Result The postoperative fibrinogen(Fib)level of the DVT group was higher than that of the control group(P<0.05);preoperative D-dimer(D-D)>0.74 mg/L,preoperative Fib>3.46 g/L,postoperative Fib>3.54 g/L,postoperative bed rest>72 h,preoperative chemotherapy are independent risk factors for lower limb DVT after thoracoscopic lung cancer resection(P<0.05).Conclusion Increased preoperative D-D and Fib,postoperative Fib,prolonged bed rest,and preoperative chemotherapy are independent risk factors for lower extremity DVT after thoracoscopic lung cancer resection.Targeted monitoring and intervention should be carried out according to relevant factors to reduce lower extremity DVT risk.