Department of Surgical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia.
Head Neck. 2013 Oct;35(10):1410-4. doi: 10.1002/hed.23158. Epub 2012 Nov 20.
Deep venous thrombosis (DVT) and pulmonary embolism (PE) are significantly reduced with appropriate use of thromboprophylaxis and scarcely evaluated in patients undergoing oncologic head and neck surgery (OHNS).
A retrospective study on 1018 patients who underwent oncologic head and neck surgery. The records of patients with venous thromboembolism (VTE) or postoperative bleeding were reviewed for the cancer grading, management, previous known coagulopathy, anticoagulation, and general demographics.
Of a total of 1018 patients undergoing oncologic head and neck surgery, 450 patients had no chemoprophylaxis and 568 received it. The rate of a VTE event in our cohort was 0%. Twelve patients presented with hematoma or bleeding from the surgical site, 11 in the group that received chemoprophylaxis (p = .006).
Our analysis shows no benefit from chemoprophylaxis in oncologic head and neck surgery patients, with no VTE events. Our analysis shows higher rates of morbid side effects from using chemoprophylaxis, and we therefore conclude that chemoprophylaxis should not be routinely used.
适当使用血栓预防措施可显著减少深静脉血栓形成（DVT）和肺栓塞（PE），而在接受头颈部肿瘤手术的患者中，这方面的评估却很少。
对 1018 例行头颈部肿瘤手术的患者进行回顾性研究。对有静脉血栓栓塞症（VTE）或术后出血的患者的癌症分级、治疗、既往已知凝血功能障碍、抗凝和一般人口统计学资料进行了记录。
在总共 1018 例行头颈部肿瘤手术的患者中，450 例未接受化学预防，568 例接受了化学预防。我们的队列中 VTE 事件的发生率为 0%。有 12 例患者出现血肿或手术部位出血，其中 11 例发生在接受化学预防的患者中（p=0.006）。
我们的分析显示，头颈部肿瘤手术患者使用化学预防并不能带来获益，也没有 VTE 事件发生。我们的分析显示，使用化学预防会产生更高的不良副作用发生率，因此我们得出结论，不应该常规使用化学预防。
