| 摘要: |
| ［摘要］ 目的 分析肾恶性肿瘤术后患者下肢深静脉血栓形成（DVT）的危险因素并构建预测模型。方法 回顾性分析2016年1月至2021年12月于济南市第一人民医院接受手术治疗的342例肾恶性肿瘤患者的临床资料，根据住院期间下肢DVT的发生情况分为DVT组（26例）和非DVT组（316例）。应用多因素logistic回归分析肾恶性肿瘤术后患者发生下肢DVT的危险因素。以筛选得到的危险因素构建预测模型并绘制列线图。结果 DVT组年龄、女性人数比例大于非DVT组，差异有统计学意义（P<0.05）。两组体质量指数（BMI）水平，以及有吸烟史、糖尿病史、冠心病史、高血压病史的人数比例差异无统计学意义（P>0.05）。与非DVT组相比，DVT组肿瘤性质为乳头状癌、嫌色细胞癌的比例更高，手术方式为根治性肾输尿管切除的比例更大，手术时间更长，差异有统计学意义（P<0.05）。DVT组D二聚体（D-D）、超敏C反应蛋白（HsCRP）水平高于非DVT组，差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，性别为女性，以及更大的年龄、更长的手术时间、更高水平的D-D和HsCRP是肾恶性肿瘤术后患者发生下肢DVT的独立危险因素（P<0.05）。预测模型的ROC曲线下面积为0.855。结论 年龄、性别、手术时间、D-D和HsCRP与肾恶性肿瘤术后患者发生DVT具有关联性。该研究所构建的预测模型准确性良好，可为肾恶性肿瘤术后DVT的预防提供参考。 |
| 关键词: 肾恶性肿瘤 下肢深静脉血栓形成 危险因素 预测模型 |
| DOI：10.3969/j.issn.1674-3806.2022.11.12 |
| 分类号:R 543.6 |
| 基金项目: |
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| Analysis on the risk factors of lower extremity deep vein thrombosis in patients with renal malignancies after surgery and construction of a predictive model |
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LI Jing, SUN Yan
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Department of Urology, First People′s Hospital of Jinan, Shandong 250000, China
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| Abstract: |
| ［Abstract］ Objective To analyse the risk factors of lower extremity deep vein thrombosis(DVT) in patients with renal malignancies after surgery and to construct a predictive model. Methods The clinical data of 342 patients with renal malignancies who received surgical treatment in First People′s Hospital of Jinan from January 2016 to December 2021 were retrospectively analyzed. According to the occurrence of lower extremity DVT during hospitalization, the patients were divided into DVT group(26 cases) and non-DVT group(316 cases). Multivariate logistic regression was used to analyze the risk factors of lower extremity DVT in patients with renal malignancies after surgery, and the risk factors were screened out for constructing a predictive model and drawing a nomogram. Results The age of the DVT group was older than that of the non-DVT group, and the proportion of women in the DVT group was greater than that in the non-DVT group, and the differences were statistically significant(P<0.05). There were no significant differences in the body mass index(BMI) level and the proportion of patients with smoking history, diabetes history, coronary heart disease history and hypertension history between the two groups(P>0.05). Compared with the non-DVT group, the DVT group had a higher proportion of tumor-type papillary carcinoma and chromophobe carcinoma, a greater proportion of radical nephroureterectomy, and longer operation time, and the differences were statistically significant(P<0.05). The levels of D-dimmer(D-D) and hypersensitive C-reactive protein(HsCRP) in the DVT group were higher than those in the non-DVT group, and the differences were statistically significant(P<0.05). The results of multivariate logistic regression analysis showed that female gender, older age, longer operation time, higher levels of D-D and HsCRP were the independent risk factors for lower extremity DVT in patients with renal malignancies after surgery(P<0.05). The area under the receiver operator characteristic(ROC) curve of the predictive model was 0.855. Conclusion Age, gender, operation time, D-D and HsCRP are associated with DVT in patients with renal malignancies after surgery. The predictive model constructed in this study has good accuracy and can provide a reference for the prevention of DVT after renal malignancies. |
| Key words: Renal malignancy Lower extremity deep vein thrombosis(DVT) Risk factor Predictive model |
