| 王丽,游菁.妇科手术后患者静脉血栓栓塞症相关危险因素分析[J].上海护理,2020,20(S1): |
| 妇科手术后患者静脉血栓栓塞症相关危险因素分析 |
| Investigate the risk factors associated with venous thromboembolism formation after gynecologic surgery |
| DOI： |
| 中文关键词: 妇科手术 静脉血栓栓塞症；危险因素 |
| 英文关键词:Gynecologic surgery Venous thromboembolism Risk factors |
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| 中文摘要: |
| 目的 研究妇科手术后患者静脉血栓栓塞症（venous thromboembolism ,VTE）发生的相关危险因素。 方法 采用电子病案管理系统收集资料，回顾性分析2010年1月-2019年8月在复旦大学附属妇产科医院行妇科手术后经多普勒超声或胸部CT检查确诊为VTE的49例患者，同时随机抽取在该时间段内行手术治疗的 320例未发生VTE 的患者作为对照组，根据入组标准，排除标准及样本量估算等将样本分为VTE组和非VTE组。研究影响妇科手术后患者VTE形成的相关危险因素，并对其进行单因素分析，同时将存在显著性差异的指标进行非条件 Logistic 多元逐步回归分析。结果 年龄＞50 岁（OR=1.376, P=0.005 ）、 BMI≥23.0kg/m2 (OR=2.237, P=0.006)、既往有心血管疾病史（OR=1.259, P = 0.004）、肺功能异常（OR=1.128, P = 0.005）、恶性肿瘤（OR=2.325, P = 0.006）、手术时间≥90min （OR = 2.276, P = 0.004）、术后D2聚体≥5.0mg ／Ｌ（OR = 1.392, P = 0.003）、纤维蛋白原≥4.5g/l（OR = 2.456, P = 0.007）、术后首次下床＞24小时（OR =1.877, P = 0.001）、术后禁食时间≥48小时（OR=1.302, P = 0.004）是妇科各类手术后深静脉血栓形成的独立危险因素(P ＜0. 05)。结论 妇科手术后VTE 的形成与患者年龄、BMI、既往有心血管疾病史、肺功能异常、恶性肿瘤、手术时间、术后血 D 二聚体、纤维蛋白原、术后卧床及禁食时间等因素密切相关，临床上应针对危险因素加以早期干预，预防VTE的发生。 |
| 英文摘要: |
| Objective To investigate the risk factors associated with venous thromboembolism formation after gynecologic surgery. Methods Data were collected from electronic medical records. 49 patients who developed VTE after gynecologic surgery at the Obstetrics and Gynecology Hospital of Fudan University from January 2010 to August 2019 were retrospectively analyzed. 320 patients without VTE were randomly selected as control group. Single factor analysis and unconditional Logistic regression analysis was performed to investigate the risk factors associated with VTE formation after gynecologic surgery. Results Age ＞50 years (OR=1.376, P=0.005), BMI≥23.0kg/m2 (OR=2.237, P=0.006), history of cardiovascular disease (OR=1. 259, P = 0.004), abnormal lung function (OR=1.128, P = 0.005), malignant tumor (OR=2.325, P = 0.006), operation time ≥90min (OR = 2.276, P = 0.004), postoperative D-dimer ≥ 5.0mg / L (OR = 1.392, P = 0.003) , postoperative fibrinogen ≥ 4.5g / L(OR = 2.456, P = 0.007), the leaving bed time> 24 hours (OR =1.877, P = 0.001) ,the fasting time ≥48 hours （OR=1.302, P = 0.004）are independent risk factors of VTE after gynecologic surgery (P < 0.05). Conclusions VTE after gynecologic surgery is closely related to many factors，including age，BMI，history of cardiovascular disease, pulmonary dysfunction, malignant tumor, operation time, postoperative blood D-dimer and fibrinogen level，postoperative bed rest, the fasting time. Clinical intervention should be made for risk factors to prevent the occurrence of VTE. |
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