卵巢恶性肿瘤临床干预前深静脉血栓发生的危险因素

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摘要目的探讨卵巢恶性肿瘤临床干预前深静脉血栓发生的危险因素。方法选取2017年6月—2019年3月在新疆医科大学第一附属医院经手术或病理诊断的卵巢癌患者110例，在临床干预前完善卵巢肿瘤标志物糖类抗原CA125和人附睾蛋白HE4、血浆D-二聚体（DD），妇科B超等相关检查。分析未治卵巢恶性肿瘤深静脉血栓的发生情况及发生的危险因素。结果研究人群在临床干预治疗前，17例患者发生了深静脉血栓，其中卵巢浆液性腺癌7例，透明细胞癌3例，未分化癌3例；其中晚期卵巢恶性肿瘤占94.2%，52.9%患者伴有大量腹水，88.2%深静脉血栓形成患者无明显临床症状。血浆DD水平≥2000 ng/mL时，血栓发生的比例明显高于其他各组，差异有统计学意义（P ＜ 0.05）。不同年龄、民族、体重指数及腹水、肿瘤标志物和特殊病理类型发生深静脉血栓比较，差异无统计学意义（P ＞ 0.05）；肿瘤体积大、肿瘤分期晚及高水平血浆DD比较，差异有统计学意义（P ＜ 0.05）。在多因素分析中，血浆DD水平≥1000 ng/mL是未治卵巢恶性肿瘤深静脉血栓发生的危险因素（OR ＞ 1，P ＜ 0.05）。结论未治卵巢恶性肿瘤深静脉血栓发生的危险因素为DD水平明显升高。

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	梁凌云赵骏达林琳

关键词 ：卵巢恶性肿瘤, D-二聚体, 深静脉血栓, 危险因素

Abstract：Objective To explore the risk factors of deep vein thrombosis before clinical intervention in ovarian malignant tumor. Methods A total of 110 ovarian malignant tumor patients in the First Affiliated Hospital of Xinjiang Medical University from January 2017 June to 2019 March were selected. Before clinical intervention, the ovarian tumor marker carbohydrate antigen CA125, human epididymal protein HE4, plasma D-dimer (DD), and gynecological B-ultrasound and other related examinations were compared. The occurrence and risk factors of deep venous thrombosis in untreated ovarian malignant tumors were analyzed. Results Before the clinical intervention, the study population developed deep vein thrombosis in 17 patients, seven cases of ovarian serous adenocarcinoma, three cases of clear cell carcinoma, and three cases of undifferentiated cancer were included. Among them, advanced ovarian malignant tumors accounted for 94.2%, and 52.9% of patients were accompanied by a large amount of ascites, and 88.2% of patients with deep vein thrombosis had no obvious clinical symptoms. When the plasma DD level was ≥2000 ng/mL, the incidence of thrombosis was significantly higher than that of the other groups, and the differences were statistically significant (P ＜ 0.05). There were no significant differences in the occurrence of deep vein thrombosis in different ages, nationalities, body mass index and ascites, tumor markers and special pathological types (P ＞ 0.05); comparisons of large tumor size, late tumor stage and high levels of plasma DD showed statistical differences significance (P ＞ 0.05). In multivariate analysis, plasma DD level ≥1000 ng/mL was a risk factor for deep vein thrombosis in untreated ovarian malignant tumors (OR ＞ 1, P ＜ 0.05). Conclusion The risk factor for deep vein thrombosis in untreated malignant ovarian tumors is significantly increased the levels of DD.

Key words： Ovarian malignant tumor D-dimer Deep venous thrombosis Risk factor

基金资助:国家自然科学基金资助项目（81671420）。

通讯作者: 林琳（1966.3-），女，博士，主任医师，硕士生导师；研究方向：妇科内分泌及妇科肿瘤。

作者简介: 梁凌云（1985.8-），女，硕士；研究方向：妇科肿瘤及妇科内分泌。

引用本文:

梁凌云赵骏达林琳. 卵巢恶性肿瘤临床干预前深静脉血栓发生的危险因素[J]. 中国医药导报, 2020, 17(29): 94-97,114.
LIANG Lingyun ZHAO Junda LIN Lin. Risk factors of deep vein thrombosis before clinical intervention in ovarian malignant tumors. 中国医药导报, 2020, 17(29): 94-97,114.

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