Study On The Risk Factors Of Lower Extremity Venous Thrombosis After Uterine Fibroids

Objective:To explore the possible risk factors for thrombosis after uterine myoma removal,and to provide valuable reference for clinical prevention of thrombosis and diagnosis and treatment.Method:Collected 108 cases of patients with uterine myomectomy in the affiliated hospital of qingda and Qingdao women and children hospital from October 2012 to October 2017.A total of 21 patients with lower extremity venous thrombosis were treated by the thrombus group,The non-thrombotic group had 87 cases without lower extremity venous thrombosis after operation.The clinical parameters of the two groups(such as age,body mass index,uterine fibroid size,etc.),operation time,operation mode,intraoperative bleeding amount,blood transfusion,D-two polymer before and after operation,hemoglobin,platelet and hematocrit difference were analyzed.To explore the risk factors that may cause postoperative thrombosis in patients.Result:1.Of the 21 patients with lower extremity venous thrombosis after surgery,17cases occurred in the left lower limb and 4 in the right lower limb.The earliest patients with obvious clinical manifestations were 3 days after surgery and 18 days after surgery.The main focus is 4-10 days.2.The age of the two groups was(45.32,±4.071)and(44.76±5.915) years old.The body mass index(BMI)of the two groups was(23.909±2.1817)kg/m~2(23.02±2.2764)kg/m~2.According to the statistical analysis,the differences in age and body mass index of the two groups were not statistically significant(P>0.05).3.The average operation time of the thrombus group was 194.9 minutes,and the average operation time of the non-thrombotic group was 126.21 minutes,and the single factor analysis was statistically significant(P<0.001,t=6.081).4.Blood transfusion is one of the risk factors for the formation of lower extremity venous thrombosis.5.The incidence of thrombosis was 12%in laparotomy and 21.69%in laparoscopic surgery.The chi-square test was performed by two groups of surgical methods,and there was no statistically significant difference in the postoperative lower limb vein thrombosis.6.In this study,the sensitivity of d-dimer was 90.5%and specificity was 54%.7.There was a statistically significant difference in bleeding volume between the two groups(OR=3.012,P=0.002),suggesting that the more blood loss during operation,the higher the risk of postoperative thrombosis.8.The difference in platelet difference between the two groups was statistically significant(OR=7.688,P=0.014)before and after operation,indicating that there was a greater risk of thrombosis after surgery.Conclusion:The choice of operation mode of uterine fibroids does not affect the incidence of deep vein thrombosis after operation.The d-dimer is an important risk factor for the evaluation of thrombosis,but it has higher sensitivity and lower specificity;Intraoperative blood loss,blood transfusion is to promote uterine fibroids to eliminate one of the risk factors of lower extremity deep venous thrombosis after,preoperative postoperative platelet's change can be a reminder factor of postoperative thrombosis,as preoperative postoperative platelet difference,the greater the risk of venous thrombosis of lower limbs.It can prompt clinicians to intervene early and reduce the incidence of deep vein thrombosis after myomectomy.