Background: Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer.
Methods: We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admission and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT.
Results: DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05), and there was no significant difference in platelets and fibrinogen (FIB) (P>0.05).
Conclusions: The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.
【中文题目：肺癌术后患者下肢深静脉血栓的发生率 及相关危险因素分析】 【中文摘要：背景与目的 肺癌在恶性肿瘤中的发病率和死亡率居首位，已成为当前研究的热点问题。临床上根据病理类型将肺癌分为小细胞肺癌（small cell lung cancer, SCLC）和非小细胞肺癌（non-small cell lung cancer, NSCLC），其中NSCLC又包括腺癌、鳞癌及其他类型肺癌，占所有肺癌的80%左右；静脉血栓栓塞症（venous thromboembolism, VTE）包括下肢深静脉血栓（deep venous thrombosis, DVT）和肺动脉栓塞（pulmonary embolism, PE），是一种在肺癌患者中有极高的发病率和死亡率的并发症。本研究旨在明确肺癌术后患者下肢DVT的发生率，并揭示下肢DVT发生的危险因素。方法 选择天津医科大学总医院肺部肿瘤外科2021年12月-2022年12月收治的83例肺癌手术患者，入院及术后均行下肢静脉彩超检查，以分析肺癌患者术后下肢DVT的发生率；对患者的临床病例资料进行统计分析，探讨肺癌术后DVT发生的危险因素；并同期监测肺癌患者术后第1、3、5天的凝血功能和血小板，以研究其对血栓发生患者的观测价值。结果 肺癌术后患者中，发生下肢DVT为25例，发生率为30.1%，肺癌手术患者中III期+IV期及年龄>60岁者术后下肢DVT发生率更高，差异具有统计学意义（P=0.031, P=0.028）；肺癌术后血栓患者术后第1、3、5天的D-二聚体均明显高于肺癌术后非血栓患者（P<0.05），而两组纤维蛋白原（fibrinogen, FIB）和血小板间差异无统计学意义（P>0.05）。结论 我们中心肺癌术后患者DVT总体发生率为30.1%；术后中晚期、年龄较大患者更易发生DVT；其中，D-二聚体值较高的患者应考虑到VTE事件发生的可能。】 【中文关键词：肺肿瘤；术后；下肢深静脉血栓；发生率；危险因素】.
Keywords: Deep venous thrombosis; Incidence; Lung neoplasms; Postoperative; Risk factors.