恶性肿瘤合并静脉血栓栓塞症的临床特点及相关危险因素分析

发布时间：2018-12-26 08:15

【摘要】：目的探讨恶性肿瘤合并静脉血栓栓塞症(VTE)的临床特点和相关危险因素。方法收集恶性肿瘤合并VTE的患者177例为研究组,并以同期入院的恶性肿瘤但未合并VTE的100例患者为对照组,回顾性分析并比较2组患者的临床资料及可能存在的危险因素。结果 VTE多发生在恶性肿瘤确诊的3月内,以肺癌最常见。高龄、合并疾病、白细胞计数增高、血红蛋白降低、凝血酶原时间增高、活化的部分凝血活酶时间增高、纤维蛋白原增高、D-二聚体增高在研究组中发生率较高,与对照组比较,差别有统计学意义(P0.05);合并糖尿病、冠心病、感染、长期卧床、VTE病史、肿瘤压迫、接受化疗、生物治疗、中心静脉置管、激素治疗、止血药治疗、粒细胞集落刺激因子治疗、输血等,研究组的发生比例较对照组高,差别有统计学意义(P0.05)。多因素Logistic回归分析结果显示,合并冠心病、中心静脉置管、接受激素治疗为恶性肿瘤合并VTE的独立危险因素(P0.05);感染是恶性肿瘤合并VTE或肺栓塞的独立危险因素(P0.05)。结论有冠心病、中心静脉置管、感染、接受激素治疗的恶性肿瘤患者易发生VTE,其中感染是恶性肿瘤合并肺栓塞的高危因素。
[Abstract]:Objective to investigate the clinical features and related risk factors of malignant tumor with venous thromboembolism (VTE). Methods 177 patients with malignant tumor complicated with VTE were selected as study group and 100 patients with malignant tumor who were admitted to hospital but not with VTE as control group. The clinical data and possible risk factors were retrospectively analyzed and compared between the two groups. Results VTE mostly occurred within 3 months after the diagnosis of malignant tumor, lung cancer was the most common. Old age, complicated diseases, increased white blood cell count, decreased hemoglobin, increased prothrombin time, increased activated partial thromboplastin time, increased fibrinogen, and increased D-dimer were found in the study group. Compared with the control group, the difference was statistically significant (P0.05). Diabetes, coronary heart disease, infection, long-term bed rest, history of VTE, tumor compression, chemotherapy, biotherapy, central venous catheterization, hormone therapy, hemostatic therapy, granulocyte colony stimulating factor therapy, blood transfusion, etc. The incidence rate of the study group was higher than that of the control group, the difference was statistically significant (P0.05). Multivariate Logistic regression analysis showed that coronary heart disease, central venous catheterization and hormone therapy were independent risk factors for malignant tumor complicated with VTE (P0.05). Infection was an independent risk factor for malignant tumor associated with VTE or pulmonary embolism (P0.05). Conclusion patients with coronary heart disease, central venous catheterization, infection and hormone therapy are prone to VTE,. Infection is a high risk factor for malignant tumor complicated with pulmonary embolism.
【作者单位】：福建医科大学附属第一医院化疗科;
【分类号】：R543.6;R73

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