肺癌手术患者术后发生静脉血栓栓塞症的危险因素分析

Risk factors analysis of venous thromboembolism in patients underwent the lung cancer operation

目的探讨肺癌手术患者术后发生静脉血栓栓塞症(venous thromboembolism,VTE)的危险因素。方法选择医院2017年3月—2019年8月收治的肺癌手术患者160例为研究对象,将发生VTE患者43例作为病例组,未发生VTE患者117例为对照组,通过单因素分析、多因素Logistic回归分析,筛选肺癌手术患者术后发生VTE的影响因素。结果单因素分析显示,年龄、合并高血压、合并冠心病、Caprini评分、术前血清白蛋白、手术时间是肺癌手术患者术后发生VTE的相关因素(P<0.05);多因素Logistic回归分析显示,年龄≥65岁、术前血清白蛋白≤35 g/L、合并高血压、合并冠心病、手术时间≥120 min是肺癌手术患者术后发生VTE的独立危险因素(P<0.05)。结论近年来肺癌手术患者术后VTE发生率逐年上升,年龄≥65岁、术前血清白蛋白≤35 g/L,手术时间≥120 min,对于此类人群,术后极易发生VTE,术前应注意VTE早期预警,采取必要的预防护理措施,规范抗凝药物的使用。

Objective To investigate the risk factors of postoperative venous thromboembolism(VTE) in lung cancer patients. Methods To select 160 lung cancer operation patients admitted in the hospital from March 2017 to August 2019 as the study objects, 43 patients occured VTE were set as case group, 117 patients unoccurred VTE were set as control group. By operating the univariate analysis and multivariate Logistic regression analysis to select the influencing factors of the lung cancer operation patients occurred the VTE after operation. Results Univariate analysis showed that age, complicated hypertension, comlicated with coronary heart disease Caprini score, preoperative serum albumin and operation time were the related factors of the postoperative VTE occurrence(P <0.05);multivariate Logistic regression analysis showed that age ≥ 65 years old, preoperative serum albumin ≤ 35 g/L, hypertension, coronary heart disease and operation time ≥ 120 min were independent risk factors of VTE after lung cancer operation(P<0.05). Conclusion Recently years, the incidence of VTE in lung cancer patients after surgery was increased. Patients with age ≥ 65 years old, preoperative serum albumin ≤ 35 g/L, with operation time ≥ 120 min were prone to VTE after operation. Early warning of VTE before surgery, necessary preventive and nursing measures and standardize the use of anticoagulants should be paid more attention.