在接受性结肠炎的阴道囊手术的患者需要扩展静脉血栓预防吗?
Javier Gomez1,2, Evangelia Theodosopoulos1,2, Helen MacRae1,2
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
概括
对于性结肠炎 (UC) 手术后的静脉血栓栓塞事件 (VTE) 发生在6.3%的囊-门缩 (IPAA) 手术中,主要是在住院期间. 对这些患者来说,可能不会经常支持扩展VTE预防.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 血管外科 血管外科
背景情况:
- 静脉血栓栓塞事件 (VTE) 是重要的手术并发症.
- 在结直肠癌手术后,延长VTE预防 (4周) 是标准的.
- 在炎症性肠病 (IBD) 手术后进行延长VTE预防的证据有限.
研究的目的:
- 为了评估VTE的几率在30天内,以皮质囊-门解剖 (IPAA) 治疗性结肠炎 (UC).
- 为了描述静脉瘤发生 (在医院和在家) 和血栓预防使用.
- 在UC患者中,在IPAA之前的亚总切除术 (STC) 后评估VTE事件.
主要方法:
- 针对UC (2017-2021) 接受IPAA治疗的204名患者的回顾性分析.
- 评估VTE发生率,发生时间和血栓预防.
- 对116名先前有STC.患者的VTE数据的分析.
主要成果:
- 在IPAA后观察到6.3%的VTE率,其中76.9%发生在接受血栓预防治疗的住院期间.
- 在STC后的VTE率为10.3%,其中58.2%发生在医院内进行血栓预防.
- 没有血栓事件导致重新手术或死亡.
结论:
- 在UC的IPAA之后,大多数VTE发生在住院期间,尽管进行了充分的预防.
- 在这种患者群体中,可能不需要常规的延长静脉瘤预防.
- 需要进一步的研究来确定IBD手术的最佳VTE预防策略.
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