在接受手术的食道癌患者中长期vs标准血栓预防:随机对照性研究
Tua Gyldenholm1, Nina Madsen2, Niels Katballe3
1Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Health, Aarhus University, Denmark.
Journal of thrombosis and haemostasis : JTH
|January 22, 2025
概括
消化管切除术后的长期血栓预防在预防静脉血栓塞栓症方面没有益处. 手术前的前热血素片段1+2水平预测了这些患者的术后血栓形成风险.
科学领域:
- 心血管医学 心血管医学
- 手术瘤学手术瘤学
- 血液学 血液学 血液学
背景情况:
- 最近的指导方针建议在癌症治疗中进行食道切除术后的扩展性血栓预防治疗.
- 之前没有研究将长期预防与标准住院护理进行比较.
研究的目的:
- 进行第一个随机试验,评估1个月的低分子量肝素预防与标准治疗.
- 评估长期血栓预防治疗在减少术后血栓栓塞事件中的有效性.
主要方法:
- 一个开放的,随机的受控试验,涉及接受食道切除术的患者.
- 主要终点:手术后1个月前热血素片段1+2 (F1+2) 水平的差异.
- 二级终点:静脉血栓栓塞事件和死亡率.
主要成果:
- 该研究在79名患者中提前结束;1个月F1+2水平在各组之间没有差异 (P=.41).
- 静脉血栓发生率相似:13% (标准) 与15% (干预).
- 术前F1+2水平显著预测了术后静脉血栓形成 (P=0.01;OR=1.64每50 pmol/L增加).
结论:
- 长期的血栓预防在食道切除术后没有明显的益处.
- 手术前的F1+2水平是术后血栓塞栓症风险的有价值预测指标.
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