妇科恶性肿瘤患者术后肺栓塞的临床特征分析与临床防治策略OA

Objective:To investigate the clinical risk factors and strategies for the prevention and treatment of postopera-tive pulmonary embolism(PE)in patients with gynecological malignant tumors.Methods:Clinical data were collected from patients with gynecological malignancies who underwent surgical treatment at the Gynecological Oncology Department of Si-chuan Cancer Hospital between January 1,2019,and October 31,2024.Seventeen patients diagnosed with PE were as-signed to the PE group,and 182 patients without PE during the same period were randomly selected by computer as the control group.A retrospective analysis was performed to iden-tify the risk factors for PE in patients with gynecological malignancies.Results:The time to PE onset ranged from 1 to 8 days postoperatively.The main clinical symptoms were dyspnea and chest tightness,with one case presenting as asymptomatic hy-poxemia.Patients in PE group were diagnosed using computed tomographic pulmonary angiography,which demonstrated fill-ing defects in the pulmonary artery and its branches.Of these,9 patients had bilateral PE and 8 had unilateral PE.Ultra-sound examination revealed that 10 patients had concomitant lower extremity venous thrombosis.All patients in PE group had undergone open abdominal surgery and showed improvement after anticoagulant therapy with enoxaparin sodium.Univariate analysis indicated that postoperative PE in patients with gynecological malignancies was significantly associated with D-dimer levels,hemoglobin levels,white blood cell count,age,laparotomy,intraoperative blood transfusion,and underlying diseases(hypertension and diabetes)(P<0.05).Multivariate analysis further identified D-dimer level,hemoglobin level,and white blood cell count as independent risk factors for postoperative PE(P<0.05).Conclusion:Postoperative PE in pa-tients with gynecological malignancies is associated with multiple factors.For patients with elevated D-dimer,elevated white blood cell count,and decreased hemoglobin levels postoperatively,timely preventive interventions should be adopted to lower the risk of PE.In high-risk patients,postoperative symptoms such as chest tightness,dyspnea,or asymptomatic hypoxemia should raise suspicion of PE.Early diagnosis and treatment are key to reducing patient mortality.