在门诊整体手术后的深静脉血栓塞栓症
Daniel Kerekes1, Alexander Frey1, Leah Kim1
1Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
The American surgeon
|April 1, 2025
概括
门诊手术对静脉血栓塞栓症 (VTE) 的风险很低,发病率与一般人群相似. 需要进一步的研究来确定VTE预防的好处是否超过门诊环境中的风险.
科学领域:
- 一般外科 整体外科
- 血管外科 血管外科
背景情况:
- 静脉血栓塞栓症 (VTE) 是已知的住院手术的并发症.
- 门外外科手术患者的VTE风险不太清楚.
- 门诊程序越来越常见,需要进行VTE风险评估.
研究的目的:
- 审查当前关于选择性门诊整体外科手术后VTE发病率和风险因素的文献.
- 为了确定与门诊外科手术患者的VTE相关的特定风险因素.
- 为了将门诊外科手术中的VTE率与一般人口基线进行比较.
主要方法:
- 在PubMed和Embase (2000-2022) 的系统文献搜索.
- 在成人门诊整体外科手术 (不包括特定的手术类型) 中包括对VTE/PE进行同行评审的英语文章.
- 报告的VTE发病率和风险因素的分析.
主要成果:
- 十二项研究符合纳入标准;五项研究重点是胆囊切除术和修复.
- VTE/PE发病率在0.0%至0.5%之间,与一般人口的发病率相似.
- 确定的危险因素包括年龄较大,BMI较高,手术时间较长,Trendelenburg位置和肺关节.
结论:
- 选择性门诊整体外科手术的VTE风险似乎很低.
- 确定的风险因素与住院患者的风险因素一致.
- 未来的研究应该评估在门诊外科手术中进行静脉瘤预防的风险效益比.
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