外周血D⁃二聚体水平与早期胃癌及癌前病变患者ESD术后下肢深静脉血栓的相关性研究
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R735.2

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中国博士后科研资助项目(2020M671278)


Correlation between peripheral blood D ⁃dimer and deep vein thrombosis in patients with early gastric cancer and premalignant lesions underwent ESD
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    摘要:

    目的:评价不同时期测定的D-二聚体水平与早期胃癌及癌前病变患者内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)术后深静脉血栓(deep venous thrombosis,DVT)的相关性。方法:通过回顾性队列研究,分析早期胃癌及癌前病变176例患者的临床资料,其中男117例,平均年龄(62.9±9.7)岁。根据术后3 d下肢血管超声检查结果分为血栓形成组(12例)和无血栓形成组(164例),收集患者一般临床资料;Padua量表计算所有患者术后DVT风险评分;测量所有患者术前1 d、术后即刻及术后1 d的血液D-二聚体水平;分析多个变量评估ESD术后DVT的受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)及曲线下面积(area under curve,AUC);多元回归模型分析D-二聚体水平与ESD术后DVT的关系。结果:176例患者术后3 d行下肢血管超声检查,12例(6.82%)患者出现下肢DVT;两组患者术前及术后1 d D-二聚体水平差异有统计学意义(p<0.05);术后1 d的D-二聚体评估ESD术后DVT 的灵敏度、特异度及AUC 分别为91.7%、67.1 %、0.841(95% CI:0.778~ 0.892);多因素 Logistic 回归分析显示,术后 1 d D-二聚体水平与 ESD 术后 DVT 风险增高显著相关(OR:82.756,95%CI: 6.000~1 141.349,P < 0.001)。结论:早期胃癌及癌前病变患者ESD术后1 d D-二聚体水平增高与深静脉血栓风险增加相关。

    Abstract:

    Objective:This study aims to investigate the relationship between D-dimer in different periods and postoperative deep venous thrombosis(DVT)in patients with early gastric cancer and premalignant lesions underwent endoscopic submucosal dissection (ESD). Methods:A retrospective cohort study was carried out,176 patients with early gastric cancer were collected,including 117 men with an average age of(62.9±9.7)years. According to the results of vascular ultrasound examination of the lower extremities at 3 days after surgery,the patients were divided into two groups:venous thrombosis group(12 people)and non -venous thrombosis group (164 people). General clinical data of patients were collected. Postoperative DVT risk score was calculated by Padua scale. The blood D -dimer level of all patients were measured 1 day before operation,immediately after operation and 1 day after operation. The ROC curve and area under curve(AUC)of multiple variables were analyzed to predict DVT after ESD. The relationship between D -dimer level and DVT after ESD was analyzed by multiple regression model. Results:There were 176 patients underwent vascular ultrasound examination of lower extremities 3 days after surgery,and 12 patients(6.82%)had lower extremity DVT. There was statistical significance in D-dimer levels between the two groups before ESD and 1 day after ESD(all P < 0.05). The sensitivity,specificity and AUC of D - dimer 1 day after ESD to predicted DVT were 91.7%,67.1%,0.841(95% CI:0.778~0.892). Multivariate regression analysis showed that the level of D-dimer 1 day after ESD was significantly correlated with the increased risk of DVT after ESD(OR:82.756,95% CI:6.000~1 141.349,P < 0.001). Conclusion:The increased level of D - dimer 1 day after ESD is associated with an increased risk of DVT in patients with early gastric cancer and premalignant lesions underwent ESD.

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陈丽萍,林敏,霍春燕,沈洁.外周血D⁃二聚体水平与早期胃癌及癌前病变患者ESD术后下肢深静脉血栓的相关性研究[J].南京医科大学学报(自然科学版),2022,42(9):1253-1258

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  • 在线发布日期: 2022-09-14
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