| Objective: deep vein thrombosis(deep venous thrombosis,DVT)is in deep vein blood of venous reflux disorder caused by abnormal condensation inside,is the most common in the lower limb DVT in clinical,if endovascular embolic loss can lead to pulmonary embolism(PE),the annual incidence of pulmonary embolism and fatality rate is higher,but the impact of embolic loss related risk factors is not clear,in this paper,through regression methods,explores the lower extremities deep venous thrombosis after the risk factors of pulmonary embolism.Methods:Using retrospective study method,this study collected from January 2016 to January 2018 in the Second Affiliated Hospital of Anhui Medical University diagnosis of lower extremity deep vein thrombosis in patients with history data,which conforms to the inclusion criteria of a total of 142 patients,analyze the general data,such as gender,age,based on previous medical history(the cardiovascular system,respiratory system and the endocrine system,etc.),and records patients admitted to hospital with breathing rate,heart rate,blood pressure,body temperature and other vital signs,all patients were,in strict accordance with the guide to the standard of pulmonary embolism and deep venous thrombosis of the imaging examination line specification CTPA check,According to the examination results,the patients were divided into pulmonary embolism group and non-pulmonary embolism group.Statistical methods including t test,2 test and Logistic regression analysis were used to compare the difference of medical history data between the two groups,so as to explore the risk factors of pulmonary embolism after the formation of deep veins in lower limbs.Results:1.Of 142 patients with deep venous thrombosis of lower extremities,56 were in the pulmonary embolism group,29 were males and 27 were females,with an average age of 61.40±15.30 years;86 were in the non-pulmonary embolism group,including40 males and 46 females,with an average age of 60.08±15.80 years.There was no significant difference in the distribution of male and female patients between the two groups(P > 0.05),and there was significant difference in age between the two groups(P < 0.05).Among them,34 cases smoked,36 cases drank alcohol,25 cases had hyperlipidemia,58 cases had trauma or operation history in recent January,2 cases had pregnancy and puerperium,82 cases had chronic cardiovascular diseases,25 cases had chronic pulmonary diseases and 11 cases had malignant tumors,94 cases had peripheral thrombosis of lower limbs,18 cases had central thrombosis and 30 cases had mixed thrombosis.2.By comparing the related medical history of the two groups,we found that there were coronary heart disease(OR=17.41,95% CI 3.49-86.90,P<0.01),hypertension(OR=26.69,95% CI 6.68-106.62,P<0.01),valvular heart disease(OR=4.00,95% CI1.01-15.83,P=0.04),chronic lung disease(OR=2.57,95% CI 0.51-12.92,P=0.03),malignant tumors(OR=7.38,95% CI 0.90-22,P=0.04).The risk of pulmonary embolism was higher in patients with history of illness;those with traumatic surgical history(OR=4.36,95% CI 1.38-13.82,P=0.01)were more likely to develop pulmonary embolism in recent January;but there was no significant difference in age,smoking,drinking,blood pressure,length of hospital stay and location of deep venous thrombosis of lower extremities between patients and pulmonary embolism(P>0.05).3.Comparing the serological indexes of the two groups at admission,we found that there were significant differences in white blood cell count(t=-2.56,P=0.01),D-D(t=-2.10,P=0.04),and no significant differences in platelet count and PT(P > 0.05).4.Logistic regression analysis was used to further verify the correlation.Among them,trauma surgery history(OR = 4.36,95% CI 1.38-13.82,P = 0.01),coronary heart disease(OR = 17.41,95% CI 3.49-86.90,P < 0.01),hypertension(OR = 26.69,95% CI6.68-106.62,P < 0.01),cardivalve disease(OR = 4.00,95% CI 1.01-15.83,P = 0.04),chronic lung disease(OR=2.57,95%CI 0.51~12.92,P=0.03),D-D(OR = 1.10,95% CI0.99-1.11,P = 0.02)is closely related to pulmonary embolism in patients with deep venous thrombosis of lower extremities.5.Comparing the Wells score of the two groups,we found that the Wells score of the patients with pulmonary embolism was significantly higher than that of the non-pulmonary embolism group(P < 0.01).Further,the ROC curve was used to find the best cut-off point.The results showed that the risk of pulmonary embolism increased significantly when Wells score was more than 3,and the corresponding sensitivity and specificity were 98.21% and 73.26%.Conclusions: 1.Patients with lower extremity deep venous thrombosis combined with history of traumatic surgery,chronic cardiovascular disease(including coronary heart disease,hypertension,cardiac valvular disease),chronic lung disease,and history of malignant tumor are high risk factors for pulmonary embolism;2.D-D negative can exclude the possibility of pulmonary embolism3.Patients with lower extremity deep venous thrombosis were at significantly increased risk of pulmonary embolism once the Wells score was higher than 3. |
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