The risk factors for postoperative acute pulmonary embolism and the effect of anticoagulation treatment on the complication and prognosis / 医学研究生学报

ABSTRACT

Objective Postoperative acute pulmonary embolism (PE) is a high risk complication with high mortality.The aim of this study was to analyze the risk factors for postoperative acute PE and the effect of anticoagulation treatment on the complication and prognosis. Methods Ninety four postoperative patients diagnosed with acute PE by spiral CT pulmonary angiography examination from March 2011 to April 2014 were enrolled.The patients were divided into 2 groups.Group APostoperative patients without other risk fac-tors of PE (tumor, pregnancy/delivery, heart failure, COPD, long-term bedridden because of internal diseases , hypertension, coronary heart disease, stroke, atrial fibrillation and deep venous thrombosis of lower limb and PE history );Group BPostoperative patients with other risk factors of PE .The clinical data werecollected and analyzed including the risk factors of PE , examination results when PE oc-curred ( blood pressure, respiratory rate, heart rate, blood gas analysis, the level of serum D-dimer and BNP), method of treatment, bleeding complications and prognose . Results The oxygen pressure of group A was obviously higher than that of group B ( 87.36 ±23.06 mmHg vs 74.43±24.7 mmHg, P<0.05); the level of serum BNP in group A was lower than that in group B ( 945.64 ±1407.64 pg/mL vs2639.143±4070.375 pg/mL, P<0.05).The rate of anticoagulant therapy was significantly lower in group B than that in group A (90%vs 100%P<0.05) .The mortality of group B was higher than that of group A ( P<0.05) .The therapy method of anticoagulant and thromboly-sis had positive correlation with bleeding complications ( P<0.05) .The therapy method of anticoagulant had negative correlation with the mortality of acute PE, while the tumor, increase in serum BNP increasing , hypoxemia and hypotension had positive correlation with the mortality of acute PE (P<0.05). Conclusion The therapy method of anticoagulant and thrombolysis can increase the risk of bleeding complications of postoperative patients diagnosed with acute PE , while the therapy method of anticoagulant can reduce the risk of death of these patients.The tumor, increase in serum BNP , hypoxemia and hypotension can increase the risk of death .