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良性卵巢肿瘤深静脉血栓和肺血栓栓塞症的风险因素。

Risk factors for deep-vein thrombosis and pulmonary thromboembolism in benign ovarian tumor.

机构信息

Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka, Japan.

出版信息

Tohoku J Exp Med. 2011 Sep;225(1):1-3. doi: 10.1620/tjem.225.1.

Abstract

Pulmonary thromboembolism (PE) is a serious postoperative complication. Reported rates of PE following gynecologic surgery are between 0.3% and 0.8%, with deep-vein thrombosis (DVT) as the major cause (via seeding of the lungs). Benign ovarian tumors are treated principally by surgery. Possible risk factors for DVT and PE in patients with benign ovarian tumors include tumor size, patient age, and obesity. To date, however, there has been no report addressing the association of these risk factors in patients with benign ovarian tumors. This study offers a retrospective analysis of the incident of preoperative DVT by age, tumor size, and BMI in patients undergoing surgery for benign ovarian tumors. A total of 843 Japanese patients with a preoperative diagnosis of benign ovarian tumor who underwent tumorectomy or adnexectomy at our institution between July 2003 and December 2010 were enrolled. The incidence of preoperative DVT was monitored and statistically stratified by age (< 50 years and ≥ 50 years), largest tumor diameter (< 10 cm and ≥ 10 cm), and BMI (< 25 and ≥ 25). The result indicates that tumor diameter of ≥ 10 cm is not a risk factor for preoperative DVT in patients with benign ovarian tumor. On the other hand, age ≥ 50 years and BMI > 25 are independent risk factors for preoperative DVT in Japan. The patients with each risk factor should be treated with preoperative, intraoperative, and postoperative precautions against development of PE.

摘要

肺血栓栓塞症(PE)是一种严重的术后并发症。妇科手术后 PE 的报告发生率为 0.3%至 0.8%,深静脉血栓形成(DVT)是主要原因(通过肺部播种)。良性卵巢肿瘤主要通过手术治疗。良性卵巢肿瘤患者发生 DVT 和 PE 的可能危险因素包括肿瘤大小、患者年龄和肥胖。然而,迄今为止,尚无关于这些良性卵巢肿瘤患者危险因素相关性的报道。本研究对我院 2003 年 7 月至 2010 年 12 月期间接受良性卵巢肿瘤切除术或附件切除术的患者进行了术前 DVT 按年龄、肿瘤大小和 BMI 的回顾性分析。共纳入 843 例术前诊断为良性卵巢肿瘤的日本患者。监测术前 DVT 的发生率,并按年龄(<50 岁和≥50 岁)、最大肿瘤直径(<10cm 和≥10cm)和 BMI(<25 和≥25)进行统计学分层。结果表明,肿瘤直径≥10cm 不是良性卵巢肿瘤患者术前 DVT 的危险因素。另一方面,年龄≥50 岁和 BMI>25 是日本患者术前 DVT 的独立危险因素。具有每个危险因素的患者应在术前、术中、术后采取预防 PE 的措施。

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