摘要
目的分析消化系统恶性肿瘤合并静脉血栓栓塞症(venous thromboembolism,VTE)患者临床资料,探讨不同年龄段患者的临床特征。方法消化系统恶性肿瘤合并VTE患者43例,依据年龄分为老年组(≥65岁)23例和非老年组(<65岁)20例。记录2组性别、体质量指数、吸烟史、基础疾病及危险因素、肿瘤临床分期及病理分级、临床症状、血栓类型、血栓部位;比较2组入院时D-二聚体水平、白细胞计数、中性粒细胞计数等实验室检查指标;比较消化系统恶性肿瘤确诊后0~3、>3~6、>6~12、>12个月VTE发生情况及行肿瘤切除术者术后0~3、>3~6、>6~12、>12个月VTE发生情况。结果老年组冠心病(30.43%)、心功能不全(21.74%)、脑血管病(30.43%)、留置深静脉导管(26.09%)比率,双下肢静脉血栓发生率(47.83%),白细胞计数[7.79(5.30,12.53)×10^(9)/L],中性粒细胞计数[5.40(3.43,10.53)×10^(9)/L]均高于非老年组[5.00%、0、5.00%、0、15.00%、6.10(4.10,6.71)×10^(9)/L、4.03(2.17,5.07)×10^(9)/L](P<0.05),门静脉血栓发生率(0)低于非老年组(20.00%)(P<0.05),体质量指数,男性、吸烟史、糖尿病、高血压病、肺部疾病、肝脏疾病、肾脏疾病、长期卧床、化疗、手术比率,肿瘤临床分期、病理分级,临床症状,血栓类型,左下肢静脉、右下肢静脉、双肺动脉、左肺下叶静脉血栓比率,D-二聚体、血红蛋白水平,血小板计数与非老年组比较差异均无统计学意义(P>0.05)。老年组与非老年组消化系统恶性肿瘤确诊后0~3、>3~6、>6~12、>12个月及肿瘤切除术后0~3、>3~6、>6~12、>12个月VTE发生率比较差异均无统计学意义(P>0.05)。结论老年消化系统恶性肿瘤合并VTE患者心脑血管疾病、留置深静脉导管比率及双下肢静脉血栓发生率高,门静脉血栓发生率低,白细胞计数、中性粒细胞计数增高。
Objective To analyze the clinical data of malignant tumor of digestive system complicated with venous thromboembolism(VTE), and to explore the clinical characteristics of patients in different age-groups. Methods Forty-three patients with digestive system malignant tumors complicated with VTE were divided into 23 patients aged ≥65 years old(elderly group) and 20 patients aged <65 years old(non-elderly group). The age, gender, body mass index, smoking history, basic diseases, risk factors, clinical stage of tumors, pathological grade, clinical symptoms, type of thrombus and site of thrombus were recorded in two groups. The laboratory examination indexes such as D-dimer level, white blood cell count and neutrophil count on admission were detected and compared between two groups. The incidences of VTE at 0-3, >3-6, >6-12 and >12 months after diagnosis of digestive system malignant tumors, and at 0-3, >3-6, >6-12 and >12 months after tumor resection were compared. Results The percentages of coronary heart disease(30.43%), cardiac insufficiency(21.74%), cerebrovascular disease(30.43%) and deep vein catheter indwelling (26.09%),the incidence of lower limb venous thrombosis(47.83%),the white blood cell count[7.79(5.30,12.53)×10^(9)/L],and the neutrophil count[5.40(3.43,10.53)×10^(9)/L]in elderly group were significantly higher than those in non-elderly group [5.00%,0,5.00%,0,15.00%,6.10(4.10,6.71)×10^(9)/L,4.03(2.17,5.07)×10^(9)/L](P<0.05).The incidence of portal venous thrombosis was lower in elderly group(0)than that in non-elderly group(20.0%)(P<0.05).There were no significant differences in the body mass index,the percentages of male patients,smoking history,diabetes,hypertension,lung disease,liver disease,kidney disease,long-term bedding,the chemotherapy and operation,the tumor clinical stage,the pathological grade,the clinical symptoms,the thrombus type,the percentages of thrombus in the left lower limb vein,right lower limb vein,double pulmonary artery and inferior pulmonary vein,the levels of D-dimer and hemoglobin,and the platelet count between two groups(P>0.05).There were no significant differences in the incidences of VTE between elderly group and non-elderly group at 0-3,>3-6,>6-12 and>12 months after diagnosis of digestive system malignant tumors and at 0-3,>3-6,>6-12 and>12 months after tumor resection(P>0.05).Conclusion The elderly patients with digestive system malignant tumors have high percentages of cardiovascular and cerebrovascular diseases and deep vein catheter indwelling,high incidence of limb venous thrombosis,low incidence of portal venous thrombosis,and elevated counts of white blood cell and neutrophil.
作者
孙晓芳
高岚
李晓芳
吴广银
李悦
刘艳红
马汝飞
SUN Xiao-fang;GAO Lan;LI Xiao-fang;WU Guang-yin;LI Yue;LIU Yan-hong;MA Ru-fei(Department of Laboratory Medicine,Henan Provincial People’s Hospital,Zhengzhou University People’s Hospital,Zhengzhou,Henan 450003,China;Department of Digestive Diseases,Henan Provincial People s Hospital,Zhengzhou University People’s Hospital,Zhengzhou,Henan 450003,China;Department of Oncology,Henan Provincial People’s Hospital,Zhengzhou University People’s Hospital,Zhengzhou,Henan 450003,China)
出处
《中华实用诊断与治疗杂志》
2022年第1期76-79,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划省部共建项目(SB201901071)。
关键词
消化系统恶性肿瘤
静脉血栓栓塞症
深静脉血栓形成
malignant tumors of the digestive system
venous thromboembolism
deep venous thrombosis
