肺癌术后患者并发肺栓塞危险因素1∶3配对病例对照研究

doi:10.3761/j.issn.2096-7446.2025.08.002

摘要/Abstract

摘要：

目的探讨肺癌患者术后并发肺栓塞的危险因素，为医护人员预防肺癌术后患者并发肺栓塞提供参考依据。方法采用1 ∶ 3配对设计的病例对照研究方法，将宁夏回族自治区某三级甲等医院普胸外科2023年1月1日—12月31日收治的33例肺癌手术后并发肺栓塞的患者作为病例组，按照年龄（±5岁）、性别及肿瘤分期1 ∶ 3配对选取同期行肺癌手术且术后未发生肺栓塞的99例患者作为对照组。收集两组患者的临床资料，包括患者的一般信息（体重指数、术中出血量、合并症、手术时间等）、肿瘤相关情况（包括肿瘤分期、淋巴结清扫的组数等）、术前实验室指标（D-二聚体、凝血酶原时间等）以及护理工作相关内容（Caprini评分、是否使用足底静脉泵等）。采用条件Logistic回归分析探究影响肺癌患者术后并发肺栓塞的危险因素。结果回归分析结果显示，患者体重指数、术后早期开始下床活动时间、有无下肢静脉血栓、既往有无静脉血栓栓塞症（venous thromboembolism，VTE）史均为肺癌患者术后并发肺栓塞的独立影响因素。结论体重指数较高、有下肢静脉血栓、有既往VTE史以及术后早期下床活动较晚的肺癌患者术后更易并发肺栓塞。建议胸外科引入改良Caprini量表开展VTE风险评估，精细化高危群体的分级管理，从而降低肺癌患者术后肺栓塞的发生。

关键词: 肺肿瘤, 急性肺栓塞, 围手术期, 病例对照研究, 护理

Abstract:

Objective Explore the risk factors for postoperative pulmonary embolism in lung cancer patients，and provide reference for medical staff to prevent postoperative pulmonary embolism in lung cancer. Methods A case-control study using a 1 ∶ 3 ratio design was conducted to select 33 patients with postoperative pulmonary embolism in the Department of General Thoracic Surgery at a tertiary hospital in Ningxia from January 1 to December 31，2023 as the case group. 99 patients who underwent lung cancer surgery during the same period and did not develop postoperative pulmonary embolism were selected as the control group，matched 1 ∶ 3 according to age（±5 years），gender，and tumor stage. We collected the clinical data of the two groups，including the general information （such as BMI value，intraoperative bleeding，complications，operation time，etc.），tumor condition（including tumor stage，lymph node dissection group，etc.），preoperative laboratory indicators（D-dimer，prothrombin time，etc.） and content related to nursing work（Caprini score，whether to use plantar venous pump，etc.）. Conditional logistic regression analysis was used to explore the risk factors affecting postoperative complicated pulmonary embolism in patients with lung cancer. Results The results of regression analysis showed that BMI value，early postoperative ambulation，presence of lower limb venous thrombosis，previous VTE history and delay of early postoperative mobilization were independent factors of postoperative pulmonary embolism in patients with lung cancer. Conclusion Lung cancer patients with higher BMI values，lower limb venous thrombosis，previous VTE，and delayed early postoperative mobilization are more likely to develop pulmonary embolism after surgery. It is strongly recommended that the thoracic surgery department introduce the improved Caprini scale for VTE risk assessment，refine the grading management of high-risk groups，and thereby reduce the incidence of postoperative pulmonary embolism in lung cancer patients.

Key words: Lung Neoplasms, Acute Pulmonary Embolism, Perioperative, Case-Control Studies, Nursing Care

路露, 杨嘉敏, 雷新宁, 芦鸿雁, 杨丽颖. 肺癌术后患者并发肺栓塞危险因素1∶3配对病例对照研究[J]. 中华急危重症护理杂志, 2025, 6(8): 908-914.

LU Lu, YANG Jiamin, LEI Xinning, LU Hongyan, YANG Liying. Risk factors for postoperative pulmonary embolism in lung cancer surgery patients：a 1：3 paired case-control study[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 908-914.

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