在术后乳腺癌患者中静脉血栓栓塞的发生率
Jonathan Yugo Maesaka1, Yedda Nunes Reis2, Livia Menezes Elias2
1Setor de Mastologia, Divisão de Ginecologia, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, BR.
Clinics (Sao Paulo, Brazil)
|June 12, 2023
概括
静脉血栓栓塞 (VTE) 发生在0.9%的乳腺癌手术患者中. 风险因素包括特定的乳房切除类型和重建,而低分子量肝素 (LMWH) 预防降低了VTE发病率.
科学领域:
- 在瘤学瘤学.
- 血管外科 血管外科
- 流行病学 流行病学
背景情况:
- 静脉血栓塞栓症 (VTE) 是癌症患者的一个重大并发症.
- 乳腺癌手术患者面临高静脉瘤风险.
- 了解VTE频率和风险因素对于患者管理至关重要.
研究的目的:
- 为了确定经过手术的乳腺癌患者的VTE的频率.
- 为了确定与乳腺癌手术后的VTE相关的临床和瘤风险因素.
- 评估手术技术和治疗对静脉瘤发病率的影响.
主要方法:
- 在圣保罗州癌症研究所 (ICESP) 进行了一项历史性队列研究.
- 纳入标准包括在2016年1月至2018年12月期间接受手术治疗的侵袭性乳腺癌或管道癌 in situ 患者.
- 收集了有关静脉瘤诊断,手术程序和患者特征的数据.
主要成果:
- 总体VTE发病率为0.9% (15/1672名患者),其中0.2%为深静脉血栓,0.7%为肺血栓栓塞.
- 节省皮肤或节省乳头的乳房切除和立即重建 (特别是腹部片) 与更高的VTE率相关 (分别为p=0.032和p=0.033).
- 在VTE患者中观察到更长的手术时间和住院时间. 新辅助化疗和术后低分子量肝素 (LMWH) 预防与静脉瘤发作率降低相关 (分别为p=0.048和p=0.039).
结论:
- 该研究发现,乳腺癌手术患者的VTE发病率为0.9%.
- 特殊的外科手术方法,如皮肤/乳头节省乳房切除和立即腹重建,增加了静脉突发症的风险.
- 手术后的LMWH预防有效地减少了这种患者群体的静脉瘤发病率.
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