目的 分析食管癌患者静脉血栓栓塞的发病情况及相关因素。方法 回顾性分析2020-01至2023-01解放军总医院第三医学中心肿瘤科收治的466例食管癌患者的临床资料,包括一般资料[年龄、性别、体质量数(BMI)、既往史],实验室参数包括,D-二聚体、纤维蛋白原、白蛋白、血清同型半胱氨酸(HCY)、血小板。所有患者入院后进行静脉彩色多普勒超声检查,有肺部症状者进行CT肺动脉造影检查,筛查静脉血栓栓塞的发病情况。按照食管癌患者静脉血栓发生情况,分为静脉血栓栓塞组和对照组。应用多因素logistics回归模型分析影响食管癌患者发生静脉血栓栓塞的相关因素,并分析干预对策。结果 466例中,发生静脉血栓栓塞 43例,发生率为9.2%。其中上肢静脉血栓6例(13.9%);下肢静脉血栓35例(81.4%),肺静脉血栓2例(4.7%)。单因素分析结果,静脉血栓栓塞组与对照组比较,两组患者年龄、血清D-二聚体水平、纤维蛋白原、白蛋白、 HCY和血小板水平,差异有统计学意义(P＜0.05)。多因素回归分析表明,年龄、HCY、纤维蛋白原、D二聚体为食管癌患者发生静脉血栓栓塞的高风险影响因素(P＜0.05)。结论 食管癌患者静脉血栓栓塞发生率较高,大多无明显症状,下肢静脉血栓多见。年龄、HCY、纤维蛋白原、D-二聚体为食管癌患者发生静脉血栓栓塞的高风险因素。
Abstract
Objective To investigate the incidence and risk factors of venous thromboembolism in hospitalized patients with esophageal cancer. Methods Clinical data of 466 patients with esophageal cancer treated in the Third Medical Center of PLA General Hospital from January 2020 to January 2023 were retrospectively analyzed, including general data (age, sex, body mass index, past history) and laboratory parameters (D-dimer, fibrinogen, albumin, serum homocysteine, and platelet). Venous color Doppler ultrasound was performed for all patients after admission, and CT pulmonary angiography was performed for patients with pulmonary symptoms to screen the incidence of venous thromboembolism. According to the occurrence of venous thromboembolism, they were divided into venous thromboembolism group (VTE group) and control group. Logistic multivariate regression analysis was used to summarize the related factors affecting the occurrence of venous thromboembolism and then the intervention strategies were discussed. Results Among 466 cases, venous thromboembolism occurred in 43 cases (9.2%). There were 6 cases (13.9%) of venous thrombosis in upper extremity.There were 35 cases (81.4%) of venous thrombosis in lower extremity and 2 cases (4.7%) of pulmonary venous thrombosis. Univariate analysis showed that the levels of age, serum D-dimer, fibrinogen, serum homocysteine (HCY) and platelet in the venous thromboembolism group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). Multivariate unconditional Logistic regression analysis showed that age, serum D-dimer level, fibrinogen and HCY were the risk factors for venous thrombosis (P<0.05). Conclusions The incidence of venous thromboembolism in hospitalized patients with esophageal cancer is high, most of the patients are asymptomatic and lower limb venous thrombosis is common. Age, serum D-dimer level, fibrinogen, and serum HCY are independent risk factors for venous thromboembolism in patients with esophageal cancer.
关键词
食管癌 /
静脉血栓栓塞 /
血清同型半胱氨酸 /
纤维蛋白原 /
D-二聚体
Key words
esophageal cancer /
venous thromboembolism /
serum homocysteine /
fibrinogen /
D-dimer level
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参考文献
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