Study Of Correlation Between Calf Muscle Venous Thrombosis And Pulmonary Embolism And Risk Factors For Calf Muscle Venous Thrombosis

OBJECTIVE:To investigate the effect of calf muscle venous thrombosis(CMVT)on the occurrence of pulmonary embolism(PTE)and the risk factors of CMVT.in order to provide reference for the treatment of CMVT in clinical practice.METHODS:CMVT patients were enrolled from Qilu Hospital of Shandong University from September 2015 to August 2016.(1)Follow up all the CMVT patients to investigate the incidence of CMVT patients combined with PTE.(2)Analysis the impact of anticoagulation therapy and different anticoagulation time limit on CMVT patients with PTE.(3)Analysis the impact of immobilization on CMVT patients with PTE.(4)CMVT patients were selected as thrombosis group,and the non-CMVT patients who were hospitalized at the same time were selected as the control group.CMVT was diagnosed by color doppler flow imaging(CDFI).Compare the difference between the two groups on general risk factors(age,sex.smoking history,internal medicine-related diseases),primary disease(history of surgery or immobilization,history of malignancy),current tumor-related treatment(chemotherapy,radiotherapy or endocrine therapy),laboratory indicators(platelet,total glyceride.total cholesterol,low density lipoprotein-C).Statistical analysis was performed using SPSS 22.0 statistical software.with P<0.05 as a statistically significant difference.RESULTS:A total of 654 patients were enrolled in our hospital from September 2015 to August 2016,and 486 patients were finished following up.Follow-up rate was 74.3%,Follow-up time was 6?12 months.(1)During the follow-up,5 patients developed PTE,the incidence was 1.03%.(2)Of all CMVT patients,104 patients were not treated with anticoagulant therapy.Among them.3 cases had PTE at the period of follow-up.The incidence was 2.9%.There were 382 patients receiving anticoagulant therapy and 2 cases of PTE occurred during follow-up period,the incidence was 0.52%.There was significant difference between the two groups(P<0.05).(3)In all patients with CMVT who received anticoagulation>10 days,there were 131 patients with anticoagulation time of 10 days?1 month.150 patients with anticoagulation time of 1 month?3 months,66 patients with anticoagulation time of 3 month-6 months and 33 patients with anticoagulation time of more than 6 months.Follow-up results showed no PTE occurred in CMVT patients with anticoagulation time>10 days.(4)Of all the CMVT patients who received anticoagulant therapy,there were 77 patients who was not immobilized,2 of them occurred PTE during follow-up period,the incidence was 2.6%,318 patients were immobilized,and no PTE occurred.There was significant difference between the two groups(P<0.05).(5)There were significant differences in the risk factors of thrombosis group and control group between age(?60Y),history of malignant tumor,current tumor-related therapy and history of operation or immobilization(P<0.05),which was regarded as CMVT related risk factors.(6)Logistic regression analysis of these risk factors showed that age(?60Y),history of malignant tumor and history of operation or immobilization were independent risk factors for CMVT formation(P<0.05).Conclusion:1.CMVT is associated with the occurrence of pulmonary embolism;2.Anticoagulation therapy can reduce the incidence of PTE in patients with CMVT;different time limit of anticoagulation therapy showed no significant difference in preventing CMVT to PTE;3.Anticoagulation combined with short-term immobilization showed better effect on preventing CMVT to PTE than other therapy;4.Age(?60 years),history of malignant tumor and history of operation or immobilization is high risk factor for CMVT formation.