胸壁肿瘤切除术后继发肺栓塞的危险因素分析

Analysis on Risk Factors of Secondary Pulmonary Embolism after Resection of Chest Wall Tumors

目的 探讨胸壁肿瘤切除术后继发肺栓塞(PE)的危险因素。方法 以90例胸壁肿瘤患者为对象,根据术后PE发生情况分为PE组(n=8)和非PE组(n=82)。收集患者的临床资料,分析影响PE发生的危险因素。结果 PE组年龄>60岁、合并糖尿病占比及白细胞计数(WBC)、 D-二聚体(D-D)水平高于非PE组,血氧分压(PO2)水平低于非PE组(P <0.05)。Logistic回归分析结果显示合并糖尿病(OR=3.785)、 PO2(OR=3.137)、 WBC (OR=4.241)、 D-D (OR=5.901)是胸壁肿瘤切除术后继发PE的独立危险因素(P <0.05)。8例PE接受治疗后未发生出血及死亡事件,症状均缓解。结论 胸壁肿瘤切除术后继发PE与患者的血氧含量低、感染、血液高凝及合并糖尿病关系密切,根据上述危险因素干预可有效预防PE的发生。

Objective To explore the risk factors of secondary pulmonary embolism(PE) after resection of chest wall tumors.Methods 90 patients with chest wall tumors were selected and divided into PE group(n = 8) and non PE group(n = 82) according to the occurrence of postoperative PE.The clinical data of patients were collected and the risk factors affecting the PE were analyzed.Results The rates of age >60 and diabetes mellitus,and white blood cell count(WBC) and D-dimmer(D-D) level in group PE were higher than those in non PE group,and the blood oxygen partial pressure(PO2) level was lower than that in non PE group(P <0.05).Logistic regression analysis showed that diabetes mellitus(OR = 3.785),PO2(OR = 3.137),WBC(OR = 4.241) and D-D(OR = 5.901) were independent risk factors for secondary PE after resection of chest wall tumors(P <0.05).No bleeding and death occurred in 8 cases of PE after treatment,and the symptoms were relieved.Conclusions Secondary PE after resection of chest wall tumors is closely related to low blood oxygen content,infection,hypercoagulability and diabetes mellitus.Intervention based on these risk factors can effectively prevent the occurrence of PE.