肺癌患者术后住院期间发生下肢深静脉血栓的危险因素

Risk factor of lower extremity deep vein thrombosis during postoperative hospitalization in patients with lung cancer

目的探讨肺癌患者术后住院期间发生下肢深静脉血栓(DVT)的危险因素。方法收集2020年1月至2022年2月于首都医科大学附属北京朝阳医院接受手术治疗的403例肺癌患者的临床资料,根据术后住院期间是否发生下肢DVT将患者分为血栓组(n=54)和对照组(n=349)。分析肺癌患者术后住院期间发生下肢DVT的危险因素。结果单因素分析结果显示,血栓组的年龄、男性患者比例、收缩压、C反应蛋白、D-二聚体水平、总胆固醇水平均高于对照组,凝血酶原时间短于对照组,体重指数和国际标准化比值均低于对照组,差异均有统计学意义(P﹤0.05)。血栓组的手术时间长于对照组,手术时间≥3 h的患者比例、TNM分期为Ⅲ~Ⅳ期的患者比例均高于对照组,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≥60岁、TNM分期为Ⅲ~Ⅳ期、D-二聚体水平升高、手术时间≥3 h均是肺癌患者术后住院期间发生下肢DVT的独立危险因素(P﹤0.05)。结论年龄≥60岁、TNM分期为Ⅲ~Ⅳ期、D-二聚体水平升高、手术时间≥3 h均与肺癌患者术后住院期间下肢DVT的发生有关,临床中应注意评估。

Objective To investigate the risk factor of lower extremity deep vein thrombosis(DVT)during postoperative hospitalization in patients with lung cancer.Method From January 2020 to February 2022,403 patients with lung cancer who received operation in Beijing CHAO-YANG Hospital,Capital Medical University were selected,and the patients were divided into thrombosis group(n=54)and control group(n=349)according to occurrence of lower extremity DVT during postoperative hospitalization.The risk factors of lower extremity DVT during postoperative hospitalization in lung cancer patients were analyzed.Result Univariate analysis showed the age,male ratio,systolic blood pressure,C-reactive protein,D-dimer level and total cholesterol level in thrombosis group were higher,the prothrombin time was shorter than that of the control group,body mass index and international normalized rate were lower than those in the control group,and the difference were statistically significant(P<0.05).The operation time of the thrombosis group was longer than that of the control group,proportion of patients with operation time≥3 hours and proportion of patients with TNM gradeⅢ~Ⅳin the thrombosis group were higher than those in the control group,and the difference were statistically significant(P<0.05).Mmultivariate analysis showed age≥60 years old,TNM grade IIIIV,increased D-dimer,and operation time≥3 hours were independent risk factors for lower extremity DVT in patients with lung cancer during postoperative hospitalization(P<0.05).Conclusion Age≥60 years old,TNM gradeⅢ~Ⅳ,increased D-dimer,and operation time≥3 hours are closely related to the occurrence of lower extremity DVT in patients with lung cancer during postoperative hospitalization,which should be evaluated in clinical practice.