| 【Objective】This study is to analyze and study the general clinical characteristics,laboratory indices,imaging data and treatment methods of patients with intermuscular vein thrombosis in the lower leg,to derive the risk factors for progression to pulmonary embolism,to provide certain methods and strategies for the prevention of progression to pulmonary embolism and treatment of patients with MCVT,to strengthen the scientific and standardized management of MCVT in the hospital,and to improve The aim is to enhance the scientific and standardized management of MCVT in the hospital,and to improve the awareness of clinicians and patients,to reduce the incidence of pulmonary embolism and to protect patient safety.【Methods】Patients with calf intermuscular vein thrombosis at the First Affiliated Hospital of Dali University were collected from July 2016 to December 2020(1)To count the incidence of calf intermuscular vein thrombosis progressing to pulmonary embolism.(2)To analyze the relationship between patients’ relevant medical history and general clinical information and the progression of intermuscular vein thrombosis of the calf to pulmonary embolism.(3)To analyze the effect of whether anticoagulation therapy was administered and the time frame of anticoagulation on the progression of intermuscular vein thrombosis in the lower leg to pulmonary embolism.(4)To analyze whether laboratory tests can be used as a test and predictor of the progression of calf intermuscular vein thrombosis to pulmonary embolism.(5)To analyze the relationship between progression to pulmonary embolism based on the limb and intermuscular venous plexus in which the patient’s intermuscular vein thrombosis is distributed.(6)The data collected were statistically analyzed by SPSS22.0,and for single factor analysis,t-test was used for measurement data and chi-square test was used for count data;while the resulting multiple factor analysis was performed by logistic regression analysis;statistical significance was obtained when P<0.05.【Results】In this study,a total of 226 patients with intermuscular vein thrombosis in the calf who underwent treatment at the First Affiliated Hospital of Dali University from July 2016 toDecember 2020 were collected,including 17 patients who progressed to pulmonary embolism and a total of 209 patients with intermuscular vein thrombosis in the calf without the occurrence of pulmonary embolism;their incidence of pulmonary embolism was about 7.52%.(1)There were 209 patients in the control group among the collected cases;the youngest patient in the control group was 27 years old and the oldest patient was 91 years old,with a mean age of 56.643.12 years;there were 17 patients in the pulmonary embolism group;the youngest patient in the pulmonary embolism group was 41 years old and the oldest patient was 86 years old,with a mean age of 63.458.27 years.The difference in age between the two groups of patients after analysis was statistically significant(P = 0.026,P < 0.05).(2)In 226 patients with MCVT there were 9 patients with malignant neoplastic disease and 217 without a history of neoplasia,and Fisher’s test was performed on them,and the results showed that the difference between the two groups was statistically significant(p = 0.023 < 0.05).(3)The number of patients with calf intermuscular vein thrombosis who underwent timely anticoagulation therapy was 210,and 12 developed pulmonary embolism;the number of patients who did not undergo anticoagulation therapy was 16,and 5 developed pulmonary embolism,and there was a statistically significant difference between the two groups after statistical analysis(p < 0.05)(3)Of the 226 patients in this study,only 47 patients underwent anticoagulation therapy for ≥3 months after discharge from the hospital,of whom 1 patient with pulmonary embolism;179 patients did not undergo anticoagulation for the full time frame,and 16 patients developed pulmonary embolism.Grouping the different time frames of anticoagulation,the statistical results showed statistical significance between the pulmonary embolism and control groups in the length of time they received anticoagulation(P < 0.01)(4)Among the 226 patients with 95 patients in the gastrocnemius plexus,2 progressed to pulmonary embolism;131 were located in the flounder muscle plexus and 15 developed pulmonary embolism.Statistical analysis showed statistical significance(P < 0.05)(5)Patients with intermuscular vein thrombosis in the calf had statistical differences in five factors: age,whether they had a history of combined malignancy,whether they received anticoagulation,the length of time they received anticoagulation,and the location of the venous plexus(P < 0.05)(6)Patients with MCVT had statistical differences in gender,medical disease(hypertension,diabetes),lipid indicators(TG,HDL-C,TC),D-dimer,and the distribution of patients’ affected limbs were not statistically significant.(7)Logistic regression analysis of the above five statistically significant factors showed that independent risk factors for progression to pulmonary embolism in patients with intermuscular plexus in the lower leg included age ≥ 60 years,history of combined malignancy,and not receiving anticoagulation.【conclusion】(1)In conjunction with this study,it can be concluded that the incidence of progression to pulmonary embolism in our patients diagnosed with intermuscular vein thrombosis of the lower extremities is approximately 7.52%.(2)Routine anticoagulation in patients with intermuscular vein thrombosis of the lower extremities and reaching a sufficient time frame of anticoagulation may reduce their progression to pulmonary embolism.(3)When patients with intermuscular vein thrombosis of the lower leg are ≥60 years of age,a history of combined malignancy,and failure to provide timely and effective anticoagulation after diagnosis are independent risk factors for progression of intermuscular vein thrombosis of the lower leg to pulmonary embolism. |
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