胃癌术后患者静脉血栓栓塞症发生现状与危险因素研究

The incidence and risk factors of postoperative Venous Thromboembolism in gastric cancer patients

目的:分析胃癌术后患者发生静脉血栓栓塞症的现状及影响因素。方法:采用连续抽样的方法,选取2020年1月至2021年12月于天津某肿瘤中心行胃癌根治术患者为研究对象,统计患者术后第6日发生血栓的情况,并分析其影响因素;用ROC曲线分析术后发生血栓时D-二聚体预测临界值。结果:372例胃癌术后患者中,106例(28.5%)发生血栓;Logistic回归分析显示,术后第1日是否下地、术后D-二聚体浓度、围手术期是否输注红细胞是胃癌术后患者发生静脉血栓栓塞症的影响因素;ROC曲线分析显示术后D-二聚体预测临界值为2584.40 ng/mL时,敏感度为79.6%,特异度为60.2%。结论:胃癌术后患者血栓发生率高,护理人员应重点关注术后第1日未下地、术后D-二聚体浓度异常增高、围手术期输注红细胞的患者,采取精准的血栓防控管理方案,降低胃癌术后患者静脉血栓栓塞症发生率。

Objective:To explore the incidence and risk factors of postoperative Venous Thromboembolism in gastric cancer patients.Methods:Consecutive sampling method was performed to select gastric cancer patients who underwent radical gastrectomy in a tumor center in Tianjin from January 2020 to December 2021.Postoperative thrombus was assessed at the postoperative day 6.The predictive thresholds of D-dimer in postoperative thrombosis were analyzed by ROC curve analysis.Results:Totally 106 patients(28.5%)developed thrombosis.Logistic regression analysis showed that,patients activity on the first day after operation,the level of D-dimer and perioperative red blood cell transfusion were the influencing factors of postoperative thrombosis in patients with gastric cancer.The sensitivity and specificity were 79.6%and 60.2%respectively when the cutoff value of D-dimer was 2584.40 ng/mL.Conclusion:The incidence of postoperative thrombus in gastric cancer patients is at high level.Nurses should pay attention to those who have abnormally high level of D-dimer and who have received red blood cell transfusion during perioperative period.Nurses could adopt precise management of thrombus prevention in order to reduce the incidence of thrombus in patients with gastric cancer after operation.