消化系统恶性肿瘤患者发生下肢深静脉血栓的影响因素分析

Analysis of the risk factor for lower extremity deep vein thrombosis in patient with digestive system malignancy

目的 探讨消化系统恶性肿瘤患者发生下肢深静脉血栓的影响因素。方法 收集2020年3月至2022年8月江苏省中医院收治的173例消化系统恶性肿瘤患者的临床资料,根据是否存在下肢深静脉血栓分为血栓组(n=31)和对照组(n=142)。采用多因素Logistic回归模型分析消化系统恶性肿瘤患者发生下肢深静脉血栓的影响因素。结果 单因素分析结果显示,血栓组患者的年龄、缺血性脑卒中史、D-二聚体水平、大腿周径差、小腿周径差、TNM分期Ⅲ~Ⅳ期、肿瘤直径均高于对照组患者,体重指数低于对照组患者,差异均有统计学意义(P<0.05)。多因素分析结果显示,年龄≥65岁、TNM分期为Ⅲ~Ⅳ期、体重指数<22 kg/m^(2)、缺血性脑卒中史、D-二聚体水平>0.5 mg/L均是消化系统恶性肿瘤患者发生下肢深静脉血栓的危险因素(P<0.05)。结论 消化系统恶性肿瘤患者下肢深静脉血栓的发生率较高,年龄≥65岁、TNM分期为Ⅲ~Ⅳ期、体重指数<22 kg/m^(2)、缺血性脑卒中史、D-二聚体水平>0.5 mg/L均是消化系统恶性肿瘤患者发生下肢深静脉血栓的危险因素,临床治疗中应注意识别高危患者,并及时进行预防。

Objective To investigate the risk factor for lower extremity deep vein thrombosis in patients with digestive system malignancy. Method The clinical data of 173 patients with digestive system malignancies admitted to Jiangsu Provincial Hospital of Chinese Medicine from March 2020 to August 2022 were collected. They were divided into thrombosis group(n=31) and control group(n=142) according to whether there was deep vein thrombosis of the lower extremities. A multivariate Logistic regression model was used to analyze the risk factor for lower extremity deep vein thrombosis in patients with digestive system malignancies. Result The results of the univariate analysis showed that the age, ischemic stroke history, D-dimer level, thigh circumference difference, calf circumference difference, TNM stage of Ⅲ-Ⅳ and tumor diameter in the thrombus group were higher than those in the control group, while the body mass index was lower than that of the control group, the differences were statistically significant(P<0.05). Multivariate analysis showed that age≥65 years, TNM stage of Ⅲ-Ⅳ, body mass index<22 kg/m^(2), ischemic stroke history, and D-dimer level > 0.5 mg/L were risk factors for lower extremity deep vein thrombosis in patients with digestive system malignancies(P<0.05). Conclusion The incidence of lower extremity deep vein thrombosis is higher in patients with malignant tumors of the digestive system. The following factors, including age ≥ 65 years, TNM stage of Ⅲ-Ⅳ, body mass index <22 kg/m^(2), history of ischemic stroke, and D-dimer level >0.5 mg/L are all risk factors for lower extremity deep vein thrombosis in patients with digestive system malignancies. There is an unmet need for clinical workers to pay more attention to identify high-risk patients by analyzing these factors, and prevent the progression in time.