耳鼻喉头颈外科静脉血栓栓塞的系统评价与荟萃分析
Systematic review and meta-analysis of venous thromboembolism in otolaryngology-head and neck surgery.
作者信息
Moubayed Sami P, Eskander Antoine, Mourad Moustafa W, Most Sam P
机构信息
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
出版信息
Head Neck. 2017 Jun;39(6):1249-1258. doi: 10.1002/hed.24758. Epub 2017 Mar 29.
BACKGROUND
The purpose of this study was to present our systematic review and meta-analysis of the data on venous thromboembolism (VTE; deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in otolaryngology-head and neck surgery (OHNS).
METHODS
PubMed and Scopus databases were searched for studies reporting VTE in OHNS. Incidence of VTE and bleeding is reported and meta-analyzed overall and for chemoprophylaxis and squamous cell carcinoma (SCC)/free flap subgroups.
RESULTS
A total of 23 studies were included with a total of 618,264 patients. Incidence of VTE was 0.4%. The incidence of bleeding complications was 0.9%. The addition of chemoprophylaxis did not result in a decreased VTE incidence (odds ratio [OR], 0.86), but produced an increased risk of bleeding (OR, 3.78). The overall OR for VTE in SCC/free flap cases was 6.28.
CONCLUSION
Chemoprophylaxis may not be necessary in the OHNS non-SCC or free flap patient population and must be balanced against an increased risk of bleeding. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1249-1258, 2017.
背景
本研究旨在对耳鼻喉头颈外科（OHNS）中静脉血栓栓塞症（VTE；深静脉血栓形成[DVT]和/或肺栓塞[PE]）的数据进行系统评价和荟萃分析。
方法
检索PubMed和Scopus数据库，查找报告OHNS中VTE的研究。报告VTE和出血的发生率，并对总体以及化学预防和鳞状细胞癌（SCC）/游离皮瓣亚组进行荟萃分析。
结果
共纳入23项研究，涉及618264例患者。VTE的发生率为0.4%。出血并发症的发生率为0.9%。添加化学预防措施并未导致VTE发生率降低（优势比[OR]，0.86），但出血风险增加（OR，3.78）。SCC/游离皮瓣病例中VTE的总体OR为6.28。
结论
在OHNS非SCC或游离皮瓣患者群体中，可能无需进行化学预防，且必须权衡出血风险增加的因素。©2017威利期刊公司。《头颈》39: 1249 - 1258, 2017。
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