肺癌化疗患者静脉血栓栓塞症危险因素及预防措施分析

Analysis of Risk Factors and Preventive Measures for Venous Thromboembolism in Patients with Lung Cancer Underwent Chemotherapy

目的探讨肺癌化疗患者发生静脉血栓栓塞症(VTE)的危险因素与其相关预防措施。方法回顾性分析85例肺癌化疗患者的临床资料,分析其发生VTE的危险因素与相关预防措施。结果85例肺癌患者化疗后并发VTE的有42例,占比为49.41%(42/85)。单因素分析显示:性别、体重指数、有无冠心病、住院时间与肺癌化疗患者发生VTE无关(P>0.05),而白细胞计数(WBC)、年龄、有无吸烟史、高血压、饮酒史、胸腔积液、D-二聚体(D-D)水平、下肢肌间有无静脉扩张与肺癌化疗患者发生VTE有关;多因素分析显示:WBC水平异常、年龄≥60岁、有吸烟史、有高血压、有饮酒史、有胸腔积液、D-D水平异常、下肢肌间静脉扩张是肺癌化疗患者发生VTE的独立危险因素(P<0.05)。结论WBC水平异常、年龄≥60岁、有吸烟史、有高血压、有饮酒史、有胸腔积液、D-D水平异常、下肢肌间静脉扩张是肺癌化疗患者发生VTE的主要影响因素,临床应据此采取预防性干预措施,以减少VTE发生。

Objective To investigate the risk factors and related preventive measures of venous thromboembolism(VTE)in patients with lung cancer underwent chemotherapy.Methods The clinical data of 85 patients with lung cancer underwent chemotherapy were retrospectively analyzed,and the risk factors and related preventive measures for VTE were analyzed.Results Of the 85 lung cancer patients,42(49.41%)were complicated with VTE after chemotherapy.Univariate analysis showed that gender,body mass index,presence or absence of coronary heart disease,and length of stay were not significantly associated with VTE in lung cancer patients undergoing chemotherapy(P>0.05);White blood cell count(WBC),age,history of smoking,hypertension,alcohol consumption,pleural effusion,D-dimer(D-D)level,and presence or absence of intramuscular venous dilation in lower limbs were significantly associated with VTE in patients with lung cancer undergoing chemotherapy(P<0.05);Multivariate analysis showed that abnormal WBC levels,age≥60 years old,a history of smoking,hypertension,a history of alcohol consumption,pleural effusion,abnormal D-D levels,and lower limb intermuscular venous dilation were independent risk factors for VTE in lung cancer patients underwent chemotherapy(P<0.05).Conclusion Abnormal WBC levels,age≥60 years old,a history of smoking,hypertension,a history of alcohol consumption,pleural effusion,abnormal D-D levels,and intermuscular venous dilation of the lower extremities are the main influencing factors for the occurrence of VTE in patients with lung cancer undergoing chemotherapy.Preventive interventions should be taken to reduce the incidence of VTE.