Analysis Of Risk Factors For Venous Thrombosis After Gynecologic Malignant Tumor Surgery

Objective:Venous thromboembolism is more prone to postoperative patients with gynecologic cancer complications,to explore the possible risk factors associated with gynecological malignant tumor postoperative venous thrombosis,so as to provide reference basis for clinical prevention work by clinician,according to the risk factors in the perioperative period to actively carry out the preventive measures to reduce the incidence and mortality rate of patients with venous thrombosis patients,improve the quality of life of patients.Methods:A retrospective case-control study was carried out in this study.69 cases were collected from November 2013 to January 2018hospitalized in the Affiliated Tumor Hospital of Guangxi Medical University,the data is complete the pathological diagnosis of gynecologic malignant tumors(cervical cancer,ovarian cancer,endometrial cancer,vulvar cancer)and clinical data of patients with VTE,which is the case group.While using the computer random method,according to the 1:1 ratio were selected with VTE in 69 cases of patients with gynecological malignant tumor clinical data as the control group.A retrospective analysis of the risk factors associated with venous thromboembolism(VTE)after a gynecologic malignant tumor surgery.The data were analyzed by SPSS17.0.Univariate analysis,for continuous variables to be normal distribution,the two sample independent t test was used between groups,and two samples rank sum test was used for comparison between groups which did not accord with normal distribution.The data of the classified variables were analyzed by X~2 test.The two element logistic regression analysis model was used in multi factor analysis.Result:1.The high risk age range of venous thrombosis after the operation of gynecologic malignant tumor is 44~63 years old.2.The high incidence of venous thrombosis after the operation of gynecologic malignant tumor is within 4~10 days after the operation.3.The main part of venous thrombosis in the gynecologic malignant tumor is the deep vein of the lower extremities,especially the deep vein of the left lower extremities.4.Single factor analysis of two groups of research objects related to general information,complication and tumor indicatorsThere was a significant difference in age,tumor stage,tumor differentiation,lymph node metastasis and complication(hypertension and diabetes)between the non thrombus group and the thrombus group(P<0.05).5.Single factor analysis of two groups of subjects related to operation,neoadjuvant chemotherapy and auxiliary examinationThere was significant difference in the amount of bleeding,blood transfusion,D-dimer before operation and D-dimer in the 3 day after operation in the group without thrombus group and thrombus group(P<0.05).6.Unconditional multiple factor Logistic regression analysis resultsMultifactor analysis showed that age,D-dimer in 3 days after operation,lymph node metastasis,and complication were independent factors affecting thrombosis(P<0.05).The higher the content of D-dimer in 3 days after operation,the greater the risk of thrombosis;lymph node metastasis in patients with the risk of thrombosis is 2.734 times of no lymph node metastasis in patients with hypertensive patients;the risk of thrombosis is 5.208 times higher than in patients without comorbidities and risk of diabetes mellitus in patients with thrombosis was 4.614 times higher than in patients without comorbidities;age(OR=0.965,95%CI:0.946-0.985,P=0.001)is the effect of independent protective factors of thrombosis,younger age,lower possibility of thrombosis.Conclusion:Postoperative venous thrombosis in gynecologic malignancies is the result of multiple factors interaction.Age,D-dimer count in 3 days after operation,lymph node metastasis,hypertension and diabetes mellitus are independent influencing factors of thrombosis.The high risk age range of venous thrombosis in gynecologic malignancies is between 44~63 years.The high incidence of venous thrombosis after the operation of gynecologic malignant tumor is within 4~10 days after operation.The main part of venous thrombosis in gynecologic malignant tumor is the deep vein of lower extremity,especially the deep vein of the left lower limb.