静脉血栓栓塞的发病率和危险因素 在直肠缩手术后发生的事件
Sarah B Jochum1, Mikhael Belkovsky, Sarah Kirschling
1Department of Colon and Rectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
Diseases of the colon and rectum
|June 5, 2025
概括
在直肠脱落手术后静脉血栓栓塞的发生率非常低 (0.32%). 关键的危险因素包括依赖性功能状态,更长的住院时间,手术部位感染和出血. 需要对化疗预防进行进一步的研究.
科学领域:
- 结肠直肠外科手术是什么意思
- 这是血管外科手术.
- 患者安全 患者安全
背景情况:
- 静脉血栓栓塞 (VTE) 是住院患者可预防死亡的主要原因.
- 虽然据报道,骨盆器官脱落手术的VTE发生率为<1%,但直肠脱落手术后的VTE发生率在很大程度上未被描述.
- 这项研究的目的是确定直肠缩手术后VTE的发病率和风险因素.
研究的目的:
- 为了确定静脉血栓塞栓症 (VTE) 事件的发生率,在直肠脱落手术后的30天内.
- 为了确定与VTE在直肠脱落修复后的发展相关的独立风险因素.
主要方法:
- 来自美国外科医生学院-国家外科质量改善计划 (2005-2021) 的19,197例直肠手术的回顾性分析.
- 利用当前的程序术语代码来识别符合条件的患者.
- 通过多变量分析评估VTE和相关风险因素的发生率.
主要成果:
- 整体VTE发生率低,为0.32% (61/19,197名患者).
- 超过60%的VTE事件发生在手术后两周内.
- 静脉瘤的独立风险因素包括依赖功能状态 (OR 2.62),更长的停留时间 (OR 1.048),术后手术部位感染 (OR 3.59) 和出血 (OR 4.35).
结论:
- 直肠脱落修复具有非常低的VTE发病率,与骨盆器官脱落手术相比较.
- 手术前的依赖性功能状态和术后的并发症,如出血和手术部位感染,是VTE的重要危险因素.
- 在本研究中无法评估术后化学预防的使用情况.
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