乳腺癌患者深静脉血栓形成的临床分析

目的研究乳腺癌患者深静脉血栓形成（DVT）的发生率, 探讨乳腺癌患者DVT的发生因素。方法收集2010年6月至2012年6月河南科技大学第一附属医院352例乳腺癌患者病历资料进行回顾性分析,依据是否发生DVT分为非血栓组（331例）和血栓组（21例）。比较2组患者基本参数的差异，包括年龄、病理类型、临床分期、既往DVT病史以及血D 二聚体值等。结果352例乳腺癌患者发生DVT者21例，DVT发生率为6.0%。血栓组患者于术后3 d发生DVT 10例（47.6%），术后3～7 d者8例（38.1%），化疗期间出现DVT者 3例（14.3%）。非血栓组患者年龄低于血栓组，组间差异有统计学意义[（49±4）岁比（57±6）岁，P＜0.05]。非血栓组与血栓组间既往有DVT病史、血D 二聚体≥500 μg/L和临床分期≥Ⅱ期的患者比例的差异有统计学意义[DVT病史：2.1%（7/331）比23.8%（5/21），血D 二聚体≥500 μg/L：6.6%（22/331）比47.6%（10/21），临床分期≥Ⅱ期：52.9%（175/331）比90.5%（19/21），均P＜0.05]。2组病理类型的差异无统计学意义（P＞0.05）。结论DVT在乳腺癌患者中具有一定的发生率, 其年龄、临床分期、D 二聚体水平等均与静脉血栓形成发生相关， 须引起临床医生的足够重视，并采取预防措施以降低静脉血栓形成及肺栓塞的发生。

Clinical analysis of the factors of deep vein thrombosis in patients with breast cancer

ObjectiveTo investigate the incidence rate of deep veins thrombosis （DVT） in breast cancer patients to identify veins thrombosis clinical factors. MethodsThe clinical data of 352 cases of breast cancer was collected from June 2010 to June 2012 in the first affiliated hospital of Henan university of science and technology. The cases were divided into non thrombotic group （331 cases） and thrombosis group （21 cases） according to whether DVT occurred. Two groups were compared regarding the basic parameters including age, histological type, clinical stage, previous history of DVT and the D dimer values. Results Veins thrombosis was found in 21 cases among 352 cases（ 6.0%）. Non thrombotic group and thrombosis group had differences in DVT history, blood D two dimer≥ 500 μg/L and clinical staging of ≥Ⅱ ratio was statistically significan[history of DVT： 2.1%（7/331） vs 23.8%（5/21）, blood D two dimer≥500 μg/L：6.6%（22/331） vs 47.6%（10/21）, clinical staging≥Ⅱ： 52.9%（175/331） vs 90.5% （19/21）, all P〈0.05]. Conclusions The incidence of veins thrombosis in breast cancer patients approaches a considerable level. It is related to s age, previous history of DVT, clinical stage, D D level, etc. The surgeons should recognize the importance to prevent venous thrombosis and pulmonary embolism in the breast cancer patients.