摘要
目的探讨根治性胃癌切除术患者术前深静脉血栓形成(DVT)的影响因素。方法收集2010年1月至2020年12月在解放军联勤保障部队第九一〇医院和解放军联勤保障部队第九〇〇医院接受根治性胃癌切除术的848例患者的临床资料,分析择期行根治性胃癌切除术患者术前DVT、肺血栓栓塞症(PTE)的发生率以及DVT的影响因素。结果848例患者中,160例患者D-二聚体检测结果为阳性,联合下肢静脉彩色多普勒超声共诊断12例DVT患者和2例患者PTE。单因素分析结果显示,发生DVT和未发生DVT患者的术前新辅助化疗、术前合并症、术中出血量比较,差异均有统计学意义(P<0.05);而发生DVT和未发生DVT患者的年龄、性别、体重指数(BMI)、分化程度、T分期、N分期、TNM分期、手术时间、手术方式比较,差异均无统计学意义(P>0.05)。将单因素分析中差异有统计学意义的因素作为自变量行Logistic回归模型分析,结果显示,新辅助化疗、术前合并肾脏疾病均是根治性胃癌切除术患者术前发生DVT的独立危险因素(P<0.05)。结论新辅助化疗、术前合并肾脏疾病均是根治性胃癌切除术患者术前发生DVT的独立危险因素。
Objective To analyze the incidence and risk factors of preoperative deep vein thrombosis(DVT)in patients undergoing elective radical gastrectomy.Method Clinical data of 848 patients undergoing radical surgery for gastric cancer at the 910th Hospital of the Joint Logistics Support Force of the Liberation Army and the 900th Hospital of the Joint Logistics Support Force of the Liberation Army from January 2010 to December 2020 were collected.The incidence of preoperative DVT and pulmonary thromboembolism(PTE),and the influencing factors of DVT in patients undergoing elective radical gastrectomy for gastric cancer were analyzed.Result Among 848 patients,160 patients D-dimer test results were positive,and 12 patients DVT were diagnosed in combination with lower extremity venous color Doppler ultrasound,2 cases were diagnosed as PTE.Univariate analysis showed that there were significant differences in preoperative neoadjuvant chemotherapy,preoperative complications and intraoperative bleeding between patients with and without DVT(P<0.05).There were no significant differences in age,sex,body mass index(BMI),degree of differentiation,T stage,N stage,TNM stage,operation time and operation mode between patients with and without DVT(P>0.05).Logistic regression analysis showed that neoadjuvant chemotherapy and preoperative renal disease were independent risk factors of DVT for gastric cancer patients(P<0.05).Conclusion Gastric cancer patients with preoperative kidney disease and preoperative neoadjuvant chemotherapy have a higher risk of DVT.
作者
李明星
陈小彬
郑凡
郭冰泉
黄建强
Li Mingxing;Chen Xiaobin;Zheng Fan;Guo Bingquan;Huang Jianqiang(Department of General Surgery,the 910th Hospital of the Joint Logistics Support Force of the Liberation Army,Quanzhou 362000,Fujian,China;Department of General Surgery,the 900th Hospital of the Joint Logistics Support Force of the Liberation Army,Fuzhou 350001,Fujian,China)
出处
《血管与腔内血管外科杂志》
2022年第4期390-394,共5页
Journal of Vascular and Endovascular Surgery
基金
福建省自然科学基金资助项目(2017J01327)。
