乳腺癌根治术后并发上肢深静脉血栓影响因素分析

【摘要】 目的 探讨乳腺癌根治术后并发上肢深静脉血栓(UEDVT)影响因素。方法 选取2015年2月至2017年2月行乳腺癌根治术的患者200例,根据术后有无并发UEDVT分为血栓组和对照组,分析不同组别乳腺癌病理类型;分析不同组别手术过程及既往史情况;测定术后1、3、6、12个月血脂总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)平均值。结果 血栓组与对照组比较,肿瘤体积更小且Ⅱ级与Ⅲ级肿瘤分布更多,basal-like型乳腺癌的比例及淋巴结转移的比例更高(均P<0.05)。血栓组与对照组比较,淋巴结清扫的比例、治疗中深静脉置管的比例、高血压或糖尿病病史比例、肥胖症比例方面均更高(均P<0.05),血液中血脂指标结果显示:TC、TG、LDL-C表达均高于对照组,HDL-C表达则低于对照组(均P<0.05),HDL-C预测UEDVT发生的ROC曲线下面积为0.92,95%置信区间为0.8635～0.9765,cut off值为1.195,敏感度65.54%,特异度95.65%。结论 乳腺癌根治术后UEDVT的发生与肿瘤的恶性程度、淋巴结转移情况、静脉置管情况、高血压与糖尿病、肥胖症等均有关联,其中血脂指标HDL-C对于预测乳腺癌根治术后UEDVT的发生具有较高的敏感度与特异度。更多还原

【Abstract】 Objective To study the risk factors analysis for deep vein thrombosis after radical mastectomy for breast cancer.Methods 200 cases of breast cancer radical mastectomy from February 2015 to February 2017 in our hospital were selected,patients were divided into thrombus group and control group according to postoperative deep venous thrombosis.The pathological types of breast cancer in different groups were analyzed,and the operation process and previous history of different groups were analyzed.The total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL-C)and low density lipoprotein(LDL-C)were measured 1 yearn after the operation.Results The thrombus group compared with the control group,the volume of the tumor was smaller and the Ⅱ and Ⅲ level tumors were more distributed.The proportion of basal-like model and the proportion of lymph node metastases were higher(P<0.05).The proportion of lymph node dissection,the proportion of deep vein catheterization in the treatment,the proportion of hypertension or diabetes,and the proportion of obesity were higher than those in the control group(all P<0.05).The blood lipid index showed that the expression of TC,TG,LDL-C were higher than that of the control group,and the expression of HDL-C was lower than that of the control group(P<0.05).HDL-C predicted that the area under the ROC curve of UEDVT was:0.92,95% confidence interval:0.8635～0.9765,cut off value 1.195,sensitivity 65.54%,specificity 95.65%.Conclusion The incidence of UEDVT after radical mastectomy are associated with the malignancy,lymph node metastasis,the venous catheterization,hypertension and diabetes history,obesity and so on.The blood lipid index HDL-C has a high sensitivity and specificity for predicting the occurrence of UEDVT after radical mastectomy for breast cancer.更多还原