国际妇产科学杂志 ›› 2019, Vol. 46 ›› Issue (2): 150-153.

• 论著 • 上一篇    下一篇

子宫内膜癌患者围手术期发生下肢深静脉血栓的影响因素

杜靖然,王妍,杨永秀   

  1. 730000 兰州大学第一医院妇产科
  • 收稿日期:2018-08-20 修回日期:2019-02-20 出版日期:2019-04-15 发布日期:2019-04-15

Risk Factors of Deep Venous Thrombosis in Patients with Endometrial Cancer during Perioperative Period

DU Jing-ran,WANG Yan,YANG Yong-xiu   

  1. Department of Obstetrics and Gynecology,First Hospital of Lanzhou University,Lanzhou 730000,China
  • Received:2018-08-20 Revised:2019-02-20 Published:2019-04-15 Online:2019-04-15

摘要: 目的:探讨子宫内膜癌患者在围手术期发生下肢深静脉血栓的相关因素。方法:回顾性分析兰州大学第一医院妇产科2013年2月—2018年7月确诊为子宫内膜癌的516例患者,以其中41例发生下肢深静脉血栓患者为血栓组,以同期41例未发生下肢深静脉血栓的子宫内膜癌患者为对照组,对2组患者的一般情况、术前实验室检查、术中情况及术后临床病理情况进行比较。结果:按照单因素分析,高血压(P=0.012)、糖尿病(P=0.018)、体质量指数(BMI,P=0.028)、血小板水平大于300×109/L(P=0.018)、胆固醇(P=0.000)、D-二聚体(P=0.023)、手术时间(P=0.025)、术中出血量(P=0.029)、淋巴结转移(P=0.012)、肿瘤分化程度(P=0.018)及肿瘤分期(P=0.002)在围手术期子宫内膜癌患者血栓组与对照组中差异具有统计学意义。Logistic回归分析显示,患者患高血压、BMI>27 kg/m2、血小板计数>300×109/L、手术时间增加、术中出血量增多、有淋巴结转移、肿瘤分化程度低、肿瘤FIGO分期晚是子宫内膜癌患者下肢深静脉血栓形成的高危因素。结论:子宫内膜癌患者伴随高血压、BMI>27 kg/m2、血小板计数>300×109/L、手术时间增加、术中出血量增多、有淋巴结转移、肿瘤分化程度低及肿瘤FIGO分期晚时,需在围手术期对上述高危因素进行控制及采取其他方法预防下肢深静脉血栓形成。

关键词: 子宫内膜肿瘤, 癌, 下肢深静脉血栓, 静脉血栓形成, 下肢, 危险因素

Abstract: Objective:To investigate the risk factors of deep venous thrombosis in patients with endometrial cancer during perioperative period. Methods: A retrospective analysis of 516 cases of endometrial cancer diagnosed in the First Hospital of Lanzhou University from February 2013 to July 2018, 41 patients with deep venous thrombosis of lower extremity were selected as experimental group and 41 patients in the same period with endometrial carcinoma as control group. The two groups were compared in general condition, preoperative laboratory examination, intraoperative status and postoperative pathology. Results: Univariate analysis showed hypertension (P=0.012), diabetes (P=0.018), body mass index (BMI, P=0.028), platelets >300×109/L (P=0.018), cholesterol (P=0.000), D-dimer (P=0.023), operative time (P=0.025), intraoperative bleeding (P=0.029), lymph node metastasis (P=0.012), tumor differentiation (P=0.018), and tumor staging (P=0.002) showed statistically significant differences between two groups. Logistic regression analysis showed that patients with hypertension, patients with BMI>27 kg/m2, platelet count>300×109/L, increased operative time, increased bleeding, increased lymph node metastasis, low tumor differentiation, tumor FIGO staging are high risk factors for deep venous thrombosis in patients with endometrial cancer. Conclusions: For endometrial cancer patients with hypertension, BMI>27 kg/m2, platelet count>300×109/L, increased operative time, increased intraoperative blood loss, lymph node metastasis, low degree of tumor differentiation and late FIGO stage, it is necessary to control the above risk factors during the perioperative period and adopt other methods to prevent lower limb deep vein thrombosis.

Key words: Endometrial neoplasms, Carcinoma, Deep vein thrombosis, Venous thrombosis, Lower extremity, Risk factors