头颈部恶性肿瘤术后急性肺栓塞临床特点及危险因素分析

doi:10.3969/j.issn.1006-7795.2022.05.019

摘要/Abstract

摘要： 目的探讨头颈部恶性肿瘤患者术后发生急性肺栓塞(acute pulmonary embolism, APE)的危险因素,为预防头颈部恶性肿瘤并发急性肺栓塞提供临床参考依据。方法采用1∶3配比设计的病例对照研究方法,对首都医科大学附属北京同仁医院头颈外科2019年1月至2020年10月收治的14例头颈部恶性肿瘤术后发生急性肺栓塞的患者和经疾病、年龄与性别匹配的42例头颈部恶性肿瘤患者进行临床资料收集,包括年龄、性别、体质量指数、吸烟史、合并基础疾病、生物化学指标及手术时间等围术期状况,采用条件Logistic回归分析探究头颈部恶性肿瘤并发急性肺栓塞的独立危险因素。结果两组患者在吸烟史、体质量指数、合并糖尿病、冠状动脉粥样硬化性心脏病(以下简称冠心病)、脑梗死、血糖、估算肾小球滤过率、血脂、尿酸、血钾、术前应用低分子肝素、围术期血压、围术期入量以及术后Caprini评分方面差异均无统计学意义(P＞0.05),但在合并高血压病和手术时间方面的差异有统计学意义(P<0.05),进一步行条件Logistic回归分析显示,高血压病、手术时间延长是头颈部肿瘤患者并发急性肺栓塞的独立危险因素。结论头颈部恶性肿瘤合并高血压病、手术时间长者并发急性肺栓塞的风险增加,改善此类危险因素可以减少此类并发症的发生,这些因素应在APE疾病中重点防治。

关键词: 头颈部恶性肿瘤, 急性肺栓塞, 临床特点, 危险因素分析

Abstract: Objective To explore the risk factors of postoperative pulmonary embolism in patients with head and neck malignancies, so as to provide clinical reference for the prevention of head and neck malignancies complicated with acute pulmonary embolism (APE). Methods With the case-control study method of 1∶3 ratio design, the clinical data of 14 patients with pulmonary embolism after head and neck cancer surgery in Beijing Tongren Hospital from January 2019 to October 2020 and 42 patients with head and neck cancer matched by disease, age and gender were collected, including age, gender, body mass index, smoking history, combined with basic diseases. The independent risk factors of head and neck malignant tumor complicated with pulmonary embolism were analyzed with conditional Logistic regression. Results There was no systematic difference in smoking history, body mass index, diabetes mellitus, coronary heart disease, cerebral infarction, blood sugar, estimated glomerular filtration rate, blood lipid, uric acid, blood potassium, preoperative application of low molecular weight heparin, perioperative blood pressure, perioperative volume and postoperative Caprini score in two groups (P> 0.05), but in combination with hypertension, the difference in operation time was statistically significant (P < 0.05). Further conditional Logistic regression analysis showed that hypertension and prolonged operation time were independent risk factors of pulmonary embolism in patients with head and neck tumors. Conclusion The head and neck malignant tumor complicated with hypertension and long operation time increased the risk of embolism. Improving these risk factors could reduce the occurrence of such complications. It should be the key prevention and treatment object of pulmonary embolism.

Key words: head and neck malignant tumor, pulmonary embolism, clinical features, risk factor analysis

中图分类号:

R563.5

张志丽, 郭彩霞. 头颈部恶性肿瘤术后急性肺栓塞临床特点及危险因素分析[J]. 首都医科大学学报, 2022, 43(5): 787-791.

Zhang Zhili, Guo Caixia. Clinical characteristics and risk factors of acute pulmonary embolism after operation for malignant head and neck tumors[J]. Journal of Capital Medical University, 2022, 43(5): 787-791.

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