2019 年第 10 期 第 14 卷

老年肺癌术后患者发生静脉血栓栓塞症的危险因素分析

Risk factors of venous thromboembolism after lung cancer surgery in elderly patients

作者：李慧罗英琳吴胜斌周明明

英文作者：

单位：533000广西壮族自治区百色市人民医院呼吸内科

英文单位：

关键词：肺癌；静脉血栓栓塞症；危险因素

英文关键词：

• 摘要：

• 【摘要】目的    探讨老年肺癌术后患者发生静脉血栓栓塞症（VTE）的危险因素。方法    选取2016年1月至2018年9月广西壮族自治区百色市人民医院收治的老年肺癌患者240例作为研究对象。收集患者临床资料，包括性别、体重指数、吸烟史、合并冠状动脉粥样硬化性心脏病（冠心病）、合并高血压、合并糖尿病、白细胞计数（WBC）异常、血小板计数（PLT）异常、D-二聚体异常、放疗、化疗、住院时间、静脉栓塞史。统计患者术后VTE发生情况。采用单因素方法和多因素Logistic回归方法分析老年肺癌术后VTE的危险因素。结果    240例老年肺癌患者发生术后VTE患者27例，发生率为11.2%。经单因素分析发现，VTE组与无VTE组性别、体重指数、合并冠心病、WBC异常、PLT异常和放疗比例及住院时间差异均无统计学意义（均P>0.05）；2组吸烟史、合并高血压、合并糖尿病、D-二聚体异常、化疗和静脉栓塞史比例差异均有统计学意义（均P<0.05）。将上述单因素分析差异有统计学意义的指标纳入多因素Logistic回归分析，结果显示，吸烟史、D-二聚体异常、化疗和静脉栓塞史为老年肺癌术后VTE的危险因素（比值比=1.986、2.264、1.537、1.729，95%置信区间：1.465～2.896、1.638～3.274、1.187～1.902、1.286～2.371，P=0.012、0.003、0.041、0.027）。结论    老年肺癌术后VTE受多因素影响，其中吸烟史、D-二聚体异常、化疗和静脉栓塞史为其危险因素。

• 【Abstract】Objective    To investigate the risk factors of venous thromboembolism(VTE) after lung cancer surgery in elderly patients. Methods    A total of 240 elderly patients with lung cancer were enrolled from January 2016 to September 2018 in People′s Hospital of Baise, Guangxi Zhuang Autonomous Region. Clinical data including gender, body mass index, smoking history, coronary heart disease, hypertension, diabetes, white blood cell count(WBC),platelet count(PLT), D-dimer, radiotherapy, chemotherapy, hospitalization time and history of venous embolism were collected. Incidence of VTE after lung cancer resection was recorded. Risk factors of VTE were analyzed by single factor method and multivariate logistic regression. Results    Incidence of VTE was 11.2%(27/240). There were no significant differences of gender, body mass index, coronary heart disease, WBC abnormality, PLT abnormality, radiotherapy and hospitalization time between VTE group and non-VTE group(all P>0.05). There were significant differences of smoking history, hypertension, diabetes, D-dimer abnormality, chemotherapy and venous embolism history between groups(all P<0.05). Logistic regression analysis showed that smoking history, D-dimer abnormality, chemotherapy and venous embolism history were risk factors of VTE(odds ratio=1.986, 2.264, 1.537, 1.729; 95% confidence interval: 1.465-2.896, 1.638-3.274, 1.187-1.902, 1.286-2.371; P=0.012, 0.003, 0.041, 0.027). Conclusion    Occurrence of VTE in elderly patients after lung cancer resection can be influenced by many factors; smoking history, D-dimer abnormality, chemotherapy and venous embolism history are risk factors of VTE.