在瘤学患者的肝切除术后与静脉血栓栓塞相关的危险因素
Brianna Greenberg1, Alexandra W Acher1, Alejandro Branes1
1Department of Surgery, Division of General Surgery, University of Toronto, Stewart Building, 149 College Street, 5th Floor, Toronto, ON, M5T 1P5, Canada; Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, T-Wing, 2075 Bayview Ave, North York, ON, M4N 3M5, Canada.
概括
主要的肝切除和显著的血液损失增加了静脉血栓栓塞 (VTE) 的风险. 经过广泛的手术,估计流血量较高的患者可能需要更密集的静脉瘤预防.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 手术瘤学手术瘤学
- 血栓塞栓症的研究研究.
背景情况:
- 切除肝脏会增加静脉血栓塞栓症 (VTE) 风险,原因是高凝血病和手术炎症.
- 目前的静脉瘤预防指南缺乏根据患者或手术因素分层.
- 外科医生的偏好往往决定了肝切除后的VTE预防实践.
研究的目的:
- 鉴定肝切除后与静脉瘤风险相关的临床因素.
- 根据手术程度和血液损失来分层VTE风险.
- 为个性化静脉瘤预防策略提供信息.
主要方法:
- 从肝切除期间出血 (HeLiX) 试验的数据分析.
- 包括因癌症而接受肝切除的患者.
- 应用单变量比较和逻辑回归分析.
主要成果:
- 在研究队列中,整体VTE发病率为4.1%.
- 严重的肝切除 (OR 2.59) 和增加估计的血液损失 (EBL) (OR 1.14每500毫升) 与更高的VTE风险显著相关.
- 随着切除的程度,VTE的发病率增加了1.7% (1-2段),5.4% (3-4段) 和6.7% (>4段).
结论:
- 主要的肝切除和大量的EBL是增加VTE风险的关键预测因素.
- 患有大量切除和较高血损失的患者可能会从更强烈的静脉瘤预防中受益.
- 研究结果表明,在肝脏外科手术中需要风险分层的VTE预防方案.
相关概念视频
Esophageal Varices-II: Clinical Features and Management
37
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
37
Esophageal Varices-I: Introduction
65
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
65
Disorders of Hemostasis
688
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
688


