Venous thromboembolism following colorectal surgery for suspected or confirmed malignancy.

Thrombosis Pub Date : 2011-01-01 Epub Date: 2011-05-26 DOI:10.1155/2011/828030
Brenton Sanderson, Kerry Hitos, John P Fletcher
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Abstract

Surgery for colorectal cancer conveys a high risk of venous thromboembolism (VTE). The effect of thromboprophylactic regimens of varying duration on the incidence of VTE was assessed in 417 patients undergoing surgery between 2005 and 2009 for colorectal cancer. Low-dose unfractionated heparin (LDUH) was used in 52.7% of patients, low-molecular-weight heparin (LMWH) in 35.3%, and 10.7% received LDUH followed by LMWH. Pharmacological prophylaxis was continued after hospitalisation in 31.6%. Major bleeding occurred in 4% of patients. The 30-day mortality rate was 1.9%. The incidence of symptomatic VTE from hospital admission for surgery to 12 months after was 2.4%. There were no in-hospital VTE events. The majority of events occurred in the three-month period after discharge, but there were VTE events up to 12 months, especially in patients with more advanced cancer and multiple comorbidities.

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因怀疑或确诊为恶性肿瘤而进行结肠直肠手术后出现静脉血栓栓塞。
结直肠癌手术具有很高的静脉血栓栓塞(VTE)风险。我们对 2005 年至 2009 年期间接受结直肠癌手术的 417 名患者进行了评估,研究了不同疗程的血栓预防方案对 VTE 发生率的影响。52.7%的患者使用了低剂量非静脉曲张肝素(LDUH),35.3%的患者使用了低分子量肝素(LMWH),10.7%的患者在使用LDUH后又使用了LMWH。31.6%的患者在住院后继续使用药物预防。4%的患者发生了大出血。30天死亡率为1.9%。从手术入院到术后12个月期间,无症状VTE的发生率为2.4%。没有发生院内 VTE 事件。大多数事件发生在出院后的三个月内,但也有 VTE 事件发生在 12 个月内,尤其是晚期癌症患者和有多种并发症的患者。
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