Epidemiological Investigation And Risk Factors Of VTE In Patients With Rectal Cancer In Single Center

Objective Venous Thromboembolism(VTE)is a class of diseases in which venous blood vessels are partially or completely blocked by blood clots.Blood clots are often composed of platelets,fibrin,and red blood cells in the venous blood.Clinically,VTE mainly includes deep vein thrombosis(DVT)and pulmonary embolism(PE).VTE has become a disease affecting human health and life worldwide.Its occurrence is occult and the clinical manifestations are nonspecific.Once PE is formed,it will seriously endanger the health of patients and even lead to sudden death.Furthermore,the patients with rectal cancer have hypercoagulable state and the change of coagulation function,and the majority of patients with middle and old age may be accompanied with internal medical diseases,all of which increase the risk of postoperative VTE.Therefore,the risk factors associated with perioperative VTE in rectal cancer patients should be fully understood,combined with the screening of high-risk groups of VTE in rectal cancer after operation,so as to achieve the purpose of prevention,early diagnosis and effective treatment of VTE.Methods 1.The number of pulmonary embolism in Shaanxi People's Hospital during 2011-2016 years was retrospectively collected and the incidence of pulmonary embolism was analyzed subsequently;2.The clinical data of rectal carcinoma diagnosed by histopathology in Shaanxi People's Hospital from October 2010 to December 2016 were retrospectively analyzed;meanwhile,epidemiological investigation was carried out,including the incidence,the general situation,and the clinical features of VTE(including clinical manifestations,thrombosis sites,thrombosis,main diagnostic methods,laboratory indicators,etc.);3.The clinical data of clinical trials of air pressure wave therapy apparatus on double lower extremities in the First Affiliated Hospital of Shaanxi People's Hospital and Shaanxi University of Chinese Medicine were collected to investigate the incidence of ultrasonographic diagnosis of DVT in both lower extremity vessels before and after rectal cancer surgery;4.In a retrospective case-control study,patients with VTE after rectal cancer were treated as thrombus group,and patients without VTE within the same period were randomly selected as the control group in the ratio of 1:10.Hospital based medical records were the sources of clinical data.Relevant clinical data were collected,including age,complications history(such as hypertension,diabetes,cardiovascular disease),tumor staging,surgical methods(including open surgery and laparoscopic surgery),chemotherapy history,intraoperative blood transfusion history,and platelet count.The relationship between these factors and the occurrence of VTE after rectal cancer surgery were then evaluated.SPSS 18 statistical software was used for data analysis,a P<0.05 was considered statistically significant.Result 1.There were a total of 524 cases of patients with PE in Shaanxi People's Hospital from 2011 to 2016,73 patients died,with a mortality rate of 13.92%;2.From October 2010 to December 2016,689 cases of patients underwent surgery for rectal cancer in Shaanxi People's Hospital,among which there were 9 cases of symptomatic VTE,and the incidence rate was 1.31%;2.In clinical trials of air pressure wave therapy apparatus on extremities,there were 60 cases of general surgery in Shaanxi People's Hospital,6 cases of DVT were diagnosed by ultrasonography,and the incidence was 10%.Among them,within 20 patients of rectal cancer,1 case was diagnosed with DVT in two lower extremities after operation,with an incidence rate of 5%.In the First Affiliated Hospital of Shaanxi University of Chinese Medicine,3 of 60 cases were diagnosed as DVT by ultrasound of double lower extremities after operation,and the incidence rate was 5%;4.Patients with age?60,combined medical diseases,advanced cancer,open surgery,preoperative chemotherapy,and platelet count?295×109/L were found to be correlated with the occurrence of VTE after rectal cancer operation;5.Patients with age?60,combined medical diseases,advanced cancer,open surgery,and platelet count?295×109/L were independent risk factors of VTE after rectal cancer surgery.Conclusion 1.Estimated mortality rate of PE was 13.92% in Shaanxi People's Hospital from 2011 to 2016;furthermore,in Shaanxi People's Hospital from October 2010 to December 2016,postoperative PE occurred in 1 patient with rectal cancer and died,suggesting poor prognosis of PE.Therefore,it is of important clinical significance for the prognosis of rectal cancer patients to give timely and effective treatment for DVT formation and avoid further development of PE.2.The incidence of VTE after rectal cancer surgery in the diagnosis of lower extremities vascular ultrasound was 5%.Far more than the incidence of symptomatic VTE after rectal cancer surgery(1.31%),With respect to the above,it is recommended for patients with rectal cancer surgery to perform an ultrasound examination of both lower extremities during the perioperative period to detect DVT.3.Preoperative double lower extremity vascular ultrasound shows no thrombosis in rectal cancer patients,and begin to use IPC during the operation.4.Patients with age?60,combined medical diseases,advanced cancer,open surgery,and platelet count?295×109/L should pay much attention to early warning,and a variety of combined preventive measures should be taken during the perioperative period to reduce the incidence of postoperative VTE.