术中干预对胰腺肿瘤患者术后发生静脉血栓栓塞的预防作用

Preventive effect of intraoperative intervention on lower extremity deep vein thrombosis after pancreatic tumor resection

目的探讨术中干预对胰腺肿瘤术后并发静脉血栓栓塞的预防作用。方法收集2017年4月至2022年12月于新疆医科大学第一附属医院接受手术治疗的912例胰腺肿瘤患者的临床资料,根据手术过程中是否采用针对性干预措施将患者分为干预组(n=469)和对照组(n=443)。比较两组患者的手术相关指标和住院期间结局指标。结果干预组患者的手术时间、术中低体温的发生率和静脉血栓栓塞的发生率均低于对照组患者,术中输液量高于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者的肿瘤类型、术后抗凝情况比较,差异均无统计学意义(P﹥0.05)。两组患者术后住院期间手术相关并发症的总发生率、病死率比较,差异均无统计学意义(P﹥0.05)。干预组胰腺癌患者术后住院期间静脉血栓栓塞的发生率低于对照组患者,差异有统计学意义(P=0.001)。结论术中干预可以明显缩短胰腺肿瘤患者手术时间,降低术中低体温的发生率,增加术中输液量,最终降低胰腺肿瘤患者术后静脉血栓栓塞的发生率,而对术后住院期间死亡风险无显著影响,值得临床推广。

Objective To investigate the preventive effect of intraoperative intervention measures on lower extremity deep vein thrombosis after pancreatic tumor resection.Method The clinical data of 912 patients with pancreatic tumors who underwent surgical treatment at the First Affiliated Hospital of Xinjiang Medical University from April 2017 to December 2022 were collected.According to whether targeted intervention measures were used during the surgery,the patients were divided into intervention group(n=469)and control group(n=443).The surgical related indicators and inpatient outcome indicators between two groups of patients were compared.Result The surgical time,incidence of intraoperative hypothermia and incidence of venous thromboembolism in the intervention group were lower than those in the control group,and the intraoperative infusion volume was higher than that in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in tumor type and postoperative anticoagulation between the two groups of patients(P>0.05).There was no statistically significant difference in the total incidence of surgical related complications and mortality rate between the two groups of patients during postoperative hospitalization(P>0.05).The incidence of venous thromboembolism in patients with pancreatic cancer in the intervention group was lower than that in the control group during postoperative hospitalization,the differences were statistically significant(P=0.001).Conclusion Intraoperative intervention can significantly shorten the surgical time of pancreatic tumor patients,reduce the incidence of intraoperative hypothermia,increase intraoperative infusion volume,and ultimately reduce the incidence of postoperative venous thromboembolism.However,it has no significant impact on the risk of death during hospitalization after surgery,which is worthy of clinical promotion.