消化管切除术后静脉血栓形成的危险因素
Naoya Torii1, Kazushi Miyata2, Masahide Fukaya1
1Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Esophagus : official journal of the Japan Esophageal Society
|January 12, 2024
概括
消化管切除术后的静脉血栓 (VT) 是一个风险. 股骨静脉中枢静脉导管 (CVC) 插入和后侧路径增加了静脉瘤的风险,而适当的手术内流体平衡可能是保护性的.
科学领域:
- 在瘤学瘤学.
- 血管外科 血管外科
- 放射学 放射学是一门学科.
背景情况:
- 静脉血栓 (VT) 是因为食道癌而经食道切除术后的一个显著的术后并发症,有可能导致致命的肺栓塞.
- 关于该患者群体中导致术后静脉治疗的特定风险因素的数据有限.
研究的目的:
- 鉴定和分析食道癌的食道切除术后与静脉血栓症 (VT) 相关的危险因素.
- 为预防静脉瘤和改善患者食道切除术后的结果提供见解.
主要方法:
- 在2006年至2019年期间,对271名因食道癌而接受食道切除术的患者进行了回顾性研究.
- 术后并发症,包括静脉瘤,使用对比度增强计算机断层扫描 (CT) 在术后第七天进行评估.
主要成果:
- 在17.7%的患者 (48/271) 中检测到静脉血栓 (VT),其中16.7% (8/48) 患有肺栓塞.
- 多变量分析确定了通过大腿静脉 (OR,7.67) 插入中央静脉导管 (CVC) 和后侧重建途径 (OR,3.94) 作为静脉瘤的独立风险因素.
- 在手术期间的液体平衡<5毫升/千克/小时被发现是对静脉瘤的保护因素 (OR,0.38).
结论:
- 通过大腿静脉插入中央静脉导管 (CVC) 和后侧静脉重建是经过食道切除术后发生静脉血栓形成 (VT) 的重要潜在风险因素.
- 保持适当的手术内流体平衡可能在预防术后静脉瘤方面发挥保护作用.
- 这些发现突出了可修改的因素,可以针对性地减少接受食道切除术的患者的静脉瘤发病率.
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