乳腺癌术后发生下肢深静脉血栓的危险因素及血栓风险评估

发布时间：2018-07-26 18:30

【摘要】：目的:研究乳腺癌患者术后发生下肢深静脉血栓(deep venous thrombosis,DVT)的危险因素,分析血栓风险评估模型的临床价值。方法:回顾性分析2013年1月至2016年6月天津医科大学肿瘤医院703例术后发生血栓的患者为血栓组,通过系统抽样法选取对照组706例,分析乳腺癌患者术后发生下肢DVT的危险因素,并比较Khorana及Caprini血栓风险评估模型的预测价值。结果:比较血栓组与对照组的年龄、BMI≥30 kg/m~2、手术切除活检确诊、接受新辅助化疗、手术时间2 h、治疗前脂蛋白a(Lpa)475.5 mg/L、血浆蛋白C(PC)102.5%、血浆凝血因子Ⅷ(FⅧ)129.8%及D-二聚体(D-D)289.99 ng/m L,差异具有统计学意义(P0.05)。两组患者的Khorana风险评估模型进行比较,差异无统计学意义(P=0.207);两组患者的Caprini风险评估模型进行比较,差异具有统计学意义(P0.001)。结论:年龄、BMI≥30 kg/m~2、手术切除活检确诊、接受新辅助化疗、手术时间2 h、治疗前Lpa475.5 mg/L、PC102.5%、FⅧ129.8%及D-D289.99 ng/m L是乳腺癌术后发生下肢DVT的独立危险因素,Caprini评估模型可能导致乳腺癌患者血栓风险评估偏高,应进一步探究更加适合乳腺癌患者血栓的风险评估模型。
[Abstract]:Objective: to study the risk factors of (deep venous thromboembolism (DVT) in patients with breast cancer after operation, and to analyze the clinical value of thrombus risk assessment model. Methods: from January 2013 to June 2016, 703 patients with postoperative thrombus in Tianjin Medical University Oncology Hospital were analyzed retrospectively. 706 patients in the control group were selected by systematic sampling. To analyze the risk factors of lower extremity DVT in breast cancer patients, and to compare the predictive value of Khorana and Caprini thrombus risk assessment models. Results: the age and BMI of thrombus group and control group were more than 30 kg / m ~ (-2), confirmed by surgical resection and biopsy, and accepted neoadjuvant chemotherapy. After 2 hours of operation, lipoprotein a (Lpa) 475.5 mg / L, plasma protein C (PC) 102.5, plasma coagulation factor 鈪，

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