Lodders J N, Parmar S, Stienen N L M, Martin T J, Karagozoglu K H, Heymans M W, Forouzanfar T
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, De Boelelaan 1118, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Edgebaston, Birmingham B15 2TH, United Kingdom.
Br J Oral Maxillofac Surg. 2015 Mar;53(3):244-50. doi: 10.1016/j.bjoms.2014.12.001. Epub 2015 Jan 29.
We retrospectively analysed the incidence of symptomatic venous thromboembolism (VTE) and associated risk factors in operations under general anaesthesia for cancer of the oral cavity. To identify symptoms related to deep venous thrombosis (DVT) and pulmonary embolism (PE), together with associated risk factors, we reviewed medical records of patients operated on in the department of oral and maxillofacial surgery at the Queen Elizabeth Hospital, Birmingham, United Kingdom, between June 2007 and October 2012. All patients were categorised according to their level of risk of VTE. The incidence of VTE was calculated with univariate associations and odds ratios with related 95% confidence intervals, where possible. In total, 233 patients were included, comprising 244 operations (mean (SD) age at operation 60.9 (13) years). Almost all patients (97%) were classified as having the highest risk of VTE. Swelling of an extremity, expectoration of blood, and tightness of the chest were the most common symptoms for suspected cases. An incidence of 0.41% was found for symptomatic VTE; one man developed a PE 2 days after operation. Associations between the analysed factors and symptomatic VTE were not significant. The development of the complication in oncological oral and maxillofacial operations seems to be rare, even in patients with a high risk. We cannot recommend the use of routine thromboprophylaxis, but it could be advocated in patients with obvious serious risk factors.
我们回顾性分析了口腔癌全身麻醉手术中症状性静脉血栓栓塞（VTE）的发生率及相关危险因素。为了确定与深静脉血栓形成（DVT）和肺栓塞（PE）相关的症状及危险因素，我们查阅了2007年6月至2012年10月期间在英国伯明翰伊丽莎白女王医院口腔颌面外科接受手术患者的病历。所有患者均根据其VTE风险水平进行分类。VTE的发生率通过单因素关联及比值比（如有可能）和相关的95%置信区间进行计算。总共纳入了233例患者，共进行了244台手术（手术时的平均（标准差）年龄为60.9（13）岁）。几乎所有患者（97%）被归类为VTE风险最高。肢体肿胀、咯血和胸部紧绷是疑似病例最常见的症状。症状性VTE的发生率为0.41%；1名男性患者术后2天发生了PE。分析的因素与症状性VTE之间的关联不显著。口腔颌面肿瘤手术中并发症的发生似乎很少见，即使是在高风险患者中。我们不建议常规使用血栓预防措施，但对于有明显严重危险因素的患者可以提倡使用。
