妇科围术期静脉血栓形成的危险因素评估

The evaluation of risk factors of gynechologic perioperative venous thromboembolic

目的探讨妇科围术期静脉血栓形成的危险因素。方法回顾分析1 970例北京大学深圳医院妇科术后患者临床资料,采用统计学方法分析患者存在的危险因素与静脉血栓形成的关系。结果 1 970例手术患者中,发病患者13例,发病率为0.7%。其中,恶性肿瘤患者发病11例,占84.6%。单因素分析中,患者年龄、糖尿病、恶性肿瘤、肿瘤期别、深间质浸润、分化程度、肿瘤转移、手术方式、手术时间、术中出血量、输血与患者静脉血栓发生有关,差异有统计学意义(P<0.05)。多因素分析中,恶性肿瘤晚期、低分化是静脉血栓形成的相关危险因素,差异有统计学意义(P<0.05)。结论年龄及糖尿病史、恶性肿瘤、手术情况与围术期静脉血栓形成有密切关系,肿瘤分期及分化程度可能是静脉血栓形成的独立危险因素。

Objective To investigate the related risk factors of patients with venous thromboembolism perio- peration. Methods Data of 1 970 cases who underwent gynecologic surgery in Peking University Shenzhen Hospital was analyzed retrospectively. The risk factors were analyzed stitistically. Results Of the 1 970 cases, there were 13 cases developing venous thromboembolism. The total incidence was 0. 7%. Among the 13 cases, 11 were malig- nant tumor, accounting for 84.6%. Univariate analysis revealed that age, diabetes mellitus, malignant tumor （in- cluding tumor stage, deep stromal invasion, tumor grade, vascular invasion, tumor metastasis）, operative type, op- erative time, blood loss, blood transfusion were related to perioperative venous thromboembosis （P〈0.05）. In the Multivariate analysis, the advanced stage of tumor and poor differentiation had statistically significant differences （P〈0.05）. Conclusions The age, diabetes mellitus, cancer and surgeries were related to the venous thromboem- bolism. In addition, stage of tumor and differentiation were independent risk factors of venous thromboembolism in gynecology.