摘要
目的 探讨高龄子宫内膜癌(EC)患者术后下肢深静脉血栓(DVT)发生的影响因素,以期为临床护理决策的制定提供参考。方法 选取2018年1月—2021年12月郑州大学第一附属医院收治并行手术治疗的156例老年EC患者为研究对象,根据术后10 d内有无发生DVT分为DVT组和非DVT组,比较2组患者的临床资料,采用Logistic回归分析术后下肢DVT发生的影响因素。结果 共26例患者术后出现下肢DVT,总发生率为16.7%。患者血栓主要发生在术后3~8 d,57.7%的患者无明显不适。单因素分析结果显示:2组患者身体质量指数(BMI)、糖尿病史、雌孕激素类药物服用史、血小板(PLT)、D-二聚体、凝血反应时间(R)、血液凝固时间(K)、凝固角(α角)、最大振幅(MA)、总胆固醇(TC)、手术时间、国际妇产科联盟(FIGO)肿瘤分期及淋巴结转移情况的差异均有统计学意义(P<0.05)。以患者是否发生DVT为因变量,以其各临床特征作为自变量,进行Logistic回归,结果表明:BMI、D-二聚体、α角、MA是患者术后下肢DVT发生的独立影响因素(P<0.05)。结论 高龄EC术后患者的BMI、D-二聚体及血栓弹力图相关参数(α角、MA)有助于预测术后DVT的发生,临床上可据此进行重点防治。
Objective This study aimed to explore the influencing factors for lower extremity deep vein thrombosis(DVT)after surgery in elderly patients with endometrial cancer(EC)to provide references for the formulation of clinical nursing decisions.Methods A total of 156 elderly EC patients who underwent surgical treatment from January 2018 to December 2021 in the First Affiliated Hospital of Zhengzhou University were selected as the research participants.According to the presence or absence of DVT within 10 days after surgery,patients were allocated to a DVT group and a non-DVT group.The clinical data of the two groups were compared,and logistic regression analysis was used to explore the influencing factors for DVT after surgery.Results A total of 26 patients developed lower extremity DVT after surgery,and the overall incidence rate was 16.7%.Thrombosis mainly occurred between 3 and 8 days after surgery,and 57.7%of the patients had no marked discomfort.Univariate analysis showed that statistically significant differences were observed in body mass index(BMI),history of diabetes,history of estrogen and progesterone drug use,platelet(PLT),D-dimer,clotting reaction time(R),blood coagulation time(K),clotting angle(αangle),maximum amplitude(MA),total cholesterol(TC),operation time,International Federation of Gynecology and Obstetrics(FIGO)tumor staging and lymph node metastasis between the groups(P<0.05).Logistic regression was performed with the presence or absence of DVT as the dependent variable and patients'clinical characteristics as independent variables.The results indicated that BMI,D-dimer,αangle,and MA were independent influencing factors for lower extremity DVT after surgery(P<0.05).Conclusion BMI,D-dimer,and thromboelastography(αangle,MA)of elderly EC patients after surgery can help predict the occurrence of DVT after surgery,and targeted prevention and treatment can be conducted clinically based on this.
作者
朱艳红
葛银
Zhu Yanhong;Ge Yin(The First Inpatient Ward of Gynecology Department,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《保健医学研究与实践》
2023年第2期70-75,共6页
Health Medicine Research and Practice
