胃肠道肿瘤患者术后下肢深静脉血栓形成的预防和处理。

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY World Journal of Gastrointestinal Surgery Pub Date : 2024-10-27 DOI:10.4240/wjgs.v16.i10.3269
Liang Shu, Cheng-Wei Xia, Yu-Fan Pang
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引用次数: 0

摘要

背景:深静脉血栓(DVT)是术后的一个重要问题,尤其是在接受胃肠道(GI)癌症手术的患者中。这些患者通常存在多种风险因素,包括高龄和体重指数(BMI)升高,这些因素都会增加血栓栓塞事件发生的可能性。对于这类高危人群来说,有效的预防措施对减少深静脉血栓和肺栓塞(PE)等并发症至关重要。目的:评估消化道癌症患者术后深静脉血栓预防策略的有效性和安全性:方法: 对2022年1月至12月期间接受消化道肿瘤手术的100名患者进行了前瞻性队列研究。所有患者都接受了标准化的深静脉血栓预防方案,包括风险评估、机械预防、药物预防和早期活动。主要终点是术后30天内深静脉血栓的发生率。次要结果包括PE发生率、出血并发症以及对方案的依从性:深静脉血栓的总发生率为 7%(7/100 例患者)。一名患者(1%)发生了 PE。预防方案的坚持率为 92%。3%的患者出现出血并发症。发生深静脉血栓的重要风险因素包括高龄[几率比(OR):1.05;95%置信区间(95%CI):1.01-1.09]、较高的体重指数(OR:1.11;95%CI:1.03-1.19)和较长的手术时间(OR:1.007;95%CI:1.001-1.013):结论:对接受消化道肿瘤手术的患者实施全面的深静脉血栓预防和管理方案可降低发病率。结论:对接受消化道肿瘤手术的患者实施全面的深静脉血栓预防和管理方案可降低发病率,严格遵守方案并进行个体化风险评估对优化治疗效果至关重要。
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Prevention and management of postoperative deep vein thrombosis in lower extremities of patients with gastrointestinal tumor.

Background: Deep vein thrombosis (DVT) is a significant postoperative concern, particularly in patients undergoing surgery for gastrointestinal (GI) cancers. These patients often present multiple risk factors, including advanced age and elevated body mass index (BMI), which can increase the likelihood of thromboembolic events. Effective prophylaxis is crucial in this high-risk population to minimize complications such as DVT and pulmonary embolism (PE). This study investigates a comprehensive DVT prevention protocol, combining mechanical and pharmacological strategies alongside early mobilization, to evaluate its effectiveness and safety in reducing postoperative thrombosis rates among GI cancer surgery patients.

Aim: To evaluate the effectiveness and safety of postoperative DVT prevention strategies in patients with GI cancer.

Methods: A prospective cohort study was conducted involving 100 patients who underwent surgery for GI tumors between January and December 2022. All patients received a standardized DVT prevention protocol, which included risk assessment, mechanical prophylaxis, pharmacological prophylaxis, and early mobilization. The primary endpoint was the incidence of DVT within 30 days postoperatively. Secondary outcomes included the occurrence of PE, bleeding complications, and adherence to the protocol.

Results: The overall incidence of DVT was 7% (7/100 patients). One patient (1%) developed PE. The adherence rate to the prevention protocol was 92%. Bleeding complications were observed in 3% of patients. Significant risk factors for DVT development included advanced age [odds ratio (OR): 1.05; 95% confidence interval (95%CI): 1.01-1.09], higher BMI (OR: 1.11; 95%CI: 1.03-1.19), and longer operative time (OR: 1.007; 95%CI: 1.001-1.013).

Conclusion: Implementing a comprehensive DVT prevention and management protocol for patients undergoing GI tumor surgery resulted in a lower incidence. Strict adherence and individualized risk assessment are crucial for optimizing outcomes.

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