Samsung Changwon Hospital, Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Changwon 630-522, Korea.
Bone Joint J. 2013 Apr;95-B(4):558-62. doi: 10.1302/0301-620X.95B4.30416.
It is important to be able to identify patients with an increased risk of venous thromboembolism (VTE) in order to minimise the risk of an event. We investigated the incidence and risk factors for post-operative VTE in 168 consecutive patients with a malignancy of the lower limb. The period of study included ten months before and 12 months after the introduction of chemical thromboprophylaxis. All data about the potential risk factors were identified and classified into three groups (patient-, surgery- and tumour-related). The outcome measure was a thromboembolic event within 90 days of surgery. Of the 168 patients, eight (4.8%) had a confirmed symptomatic deep-vein thrombosis and one (0.6%) a fatal pulmonary embolism. Of the 28 variables tested, age > 60 years, higher American Society of Anesthesiologists grade and metastatic tumour were independent risk factors for VTE. The overall rate of symptomatic VTE was not significantly different between patients who received chemical thromboprophylaxis and those who did not. Knowledge of these risk factors may be of value in improving the surgical outcome of patients with a malignancy of the lower limb.
为了降低静脉血栓栓塞（VTE）事件的风险，能够识别出具有 VTE 风险增加的患者非常重要。我们调查了 168 例下肢恶性肿瘤连续患者术后 VTE 的发生率和危险因素。研究期间包括在引入化学血栓预防措施之前的十个月和之后的十二个月。所有关于潜在危险因素的数据均被识别并分为三组（患者、手术和肿瘤相关）。主要转归为术后 90 天内发生血栓栓塞事件。在 168 例患者中，8 例（4.8%）有明确的症状性深静脉血栓形成，1 例（0.6%）有致命性肺栓塞。在 28 个测试变量中，年龄>60 岁、美国麻醉医师协会（ASA）分级较高和转移性肿瘤是 VTE 的独立危险因素。接受化学血栓预防的患者与未接受化学血栓预防的患者之间的症状性 VTE 总发生率无显著差异。了解这些危险因素可能有助于改善下肢恶性肿瘤患者的手术结果。
