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脑肿瘤开颅术后患者深静脉血栓形成的发生率及危险因素:一项日本单中心回顾性研究。

Incidence and risk factor of deep venous thrombosis in patients undergoing craniotomy for brain tumors: A Japanese single-center, retrospective study.

机构信息

Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan.

Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan.

出版信息

Thromb Res. 2018 May;165:95-100. doi: 10.1016/j.thromres.2018.03.016. Epub 2018 Mar 27.

Abstract

INTRODUCTION

It has been reported that brain tumor resection by craniotomy is a high risk for deep venous thrombosis (DVT), though few data is available in Japanese patients. The aim of this retrospective study was to evaluate the incidence and risk factors for DVT in Japanese adult patients with brain tumor surgery.

MATERIALS AND METHODS

Medical records of Japanese adult patients with craniotomy for brain tumor were reviewed. In addition to clinical variables including patients' age, sex, body mass index, previous history of DVT, leg paresis, medications, tumor histology, surgical factors, adjuvant therapy, infection, and duration of post-operative immobilization and hospitalization, plasma D-dimer levels were measured at pre-surgery (baseline), on post-operative day (POD) one to 30 and during adjuvant therapy, and were compared between patients with and without DVT.

RESULTS

Thirteen of 61 patients (21.3%) had DVT after surgery with mechanical prophylaxis. All DVTs were asymptomatic. Multivariate analyses found post-operative infection (odds ratio, 12.15; 95% confidence interval, 1.09-134.98; P = 0.03) to be a sole independent risk factor for DVT. D-dimer levels were not significantly different between patients with and without DVT at baseline and POD 1-30, but were significantly elevated during adjuvant therapy in patients with DVT (P = 0.03).

CONCLUSIONS

Not a few Japanese patients developed DVT after brain tumor surgery with mechanical prophylaxis, and patients with infection should be carefully monitored for post-operative DVT.

摘要

介绍

据报道,开颅手术切除脑肿瘤存在发生深静脉血栓(DVT)的高风险,尽管日本患者的数据较少。本回顾性研究旨在评估日本成人脑肿瘤手术患者发生 DVT 的发生率和危险因素。

材料与方法

回顾性分析了接受开颅手术治疗脑肿瘤的日本成年患者的病历。除了临床变量,包括患者年龄、性别、体重指数、既往 DVT 病史、下肢瘫痪、药物使用、肿瘤组织学、手术因素、辅助治疗、感染以及术后固定和住院时间等,还在术前(基线)、术后第 1 至 30 天和辅助治疗期间测量了患者的血浆 D-二聚体水平,并将其与有或无 DVT 的患者进行比较。

结果

13 例(21.3%)接受机械预防的患者术后发生 DVT。所有 DVT 均无症状。多因素分析发现术后感染(比值比,12.15;95%置信区间,1.09-134.98;P=0.03)是 DVT 的唯一独立危险因素。在基线和术后第 1 至 30 天,有或无 DVT 的患者的 D-二聚体水平无显著差异,但在有 DVT 的患者的辅助治疗期间显著升高(P=0.03)。

结论

接受机械预防的日本患者术后发生 DVT 的并不少见,感染患者应密切监测术后 DVT。

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