颅脑肿瘤术后并发静脉血栓栓塞症危险因素的Meta分析

Risk Factors of Venous Thromboembolism after Craniocerebral Tumor Surgery:A Meta-Analysis

目的明确颅脑肿瘤术后患者发生静脉血栓栓塞症(VTE)的危险因素。方法检索中国知网、万方、维普、中国生物医学文献、PubMed、The Cochrane Library、Web of Science、EMbase等数据库建库至2021年11月1日颅脑肿瘤术VTE危险因素的队列研究或病例对照研究。由两名研究人员独立进行文献筛选、资料提取以及文献质量评价。使用RevMan 5.4软件对纳入文献进行Meta分析。结果共纳入14篇文献,合计样本量40552例,发生VTE 1801例。Meta分析结果显示,年龄>45岁、术前D-二聚体升高、肥胖、女性、术前日常生活活动能力处于依赖状态、术前呼吸机依赖、术前曾患脓毒血症、高级神经胶质瘤、手术时间>3.05 h、术后D-二聚体升高、术后下肢运动功能障碍、术后卧床不起、术后并发尿路感染为颅脑肿瘤术后患者发生VTE的危险因素。结论颅脑肿瘤术后VTE发生与多种因素有关。建议构建颅脑肿瘤术后VTE风险预测模型,关注高风险人群,落实规范化静脉血栓风险评估,注重血栓评估过程管控。

Objective To investigate the risk factors of Venous Thromboembolism(VTE)in patients after craniocerebral tumor surgery.Methods China National Knowledge Infrastructure(CNKI),Wanfang,VIP,Chinese Biomedical Literature,PubMed,The Cochrane Library,Web of Science,EMbase and other databases were searched for cohort studies or case-control studies on VTE risk factors after craniotomy from the establishment of the databases to November 1,2021.Two researchers independently performed literature screening,data extraction and literature quality evaluation.The RevMan 5.4 software was used for Meta-analysis of the included literatures.Results A total of 14 literatures were included,with a total sample size of 40552 cases,and 1801 cases developed VTE.Meta-analysis showed that age>45 years,preoperative D-dimer elevation,obesity,female,preoperative activities of daily living dependent state,preoperative ventilator dependence,preoperative sepsis,advanced glioma,operation time>3.05 h,postoperative D-dimer elevation,postoperative lower extremity motor dysfunction,postoperative bed rest and postoperative urinary tract infection were risk factors for VTE in patients after craniocerebral tumor surgery.Conclusion The occurrence of VTE after craniocerebral tumor surgery is related to many factors.It is suggested to build a risk prediction model for VTE after craniocerebral tumor surgery,pay attention to high-risk groups,implement standardized venous thrombosis risk assessment,and pay attention to the management and control of thrombosis assessment process.