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髓外脊柱肿瘤术后静脉血栓栓塞症

Postoperative Venous Thromboembolism in Extramedullary Spinal Tumors.

作者信息

Kaewborisutsakul Anukoon, Tunthanathip Thara, Yuwakosol Pakorn, Inkate Srirat, Pattharachayakul Sutthiporn

机构信息

Neurological Surgery Unit, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkhla, Thailand.

Division of Nursing Services, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkhla, Thailand.

出版信息

Asian J Neurosurg. 2020 Feb 25;15(1):51-58. doi: 10.4103/ajns.AJNS_279_19. eCollection 2020 Jan-Mar.

Abstract

CONTEXT

Venous thromboembolism (VTE), including deep-vein thrombosis (DVT) and pulmonary embolism (PE), is the fatal complication following spine surgery and the appropriate perioperative prophylaxis is still debated.

AIMS

The aim of this study is to evaluate the incidence of along with risk factors for postoperative VTE in surgically treated extramedullary spinal tumor patients.

SETTING AND DESIGNS

The study design involves single institute and retrospective cohort study.

SUBJECTS AND METHODS

The cohort database was reviewed between the periods of January 2014 and June 2019. Patients undergoing surgery for spine tumor, extradural tumor, and intradural extramedullary were consecutively collected.

STATISTICAL ANALYSIS USED

The incidence of VTE and clinical factors reported to be associated with VTE were identified, and then analyzed with an appropriate Cox regression model.

RESULTS

The study identified 103 extramedullary spinal tumor patients. Three patients (2.9%) were diagnosed with a proximal leg DVT, while symptomatic PE did not identify. Risk factors associated with DVT occurrence were as follows: operative time ≥8 h (Hazard ratio [HR] 13.98, = 0.03) and plasma transfusion (HR 16.38, = 0.02), whereas plasma transfusion was the only significant factor, after multivariate analysis (HR 11.77, = 0.05).

CONCLUSIONS

Patients who underwent surgery for extramedullary spinal tumors showed a 2.9% incidence of DVT. The highest rate of DVT was found in patients who received plasma transfusion. More attention should be paid on perioperative associated factors for intensive prevention coupled with early screening in this group.

摘要

背景

静脉血栓栓塞症(VTE),包括深静脉血栓形成(DVT)和肺栓塞(PE),是脊柱手术后的致命并发症,围手术期的适当预防措施仍存在争议。

目的

本研究旨在评估接受手术治疗的髓外脊柱肿瘤患者术后VTE的发生率及危险因素。

设置与设计

本研究设计为单机构回顾性队列研究。

研究对象与方法

回顾2014年1月至2019年6月期间的队列数据库。连续收集接受脊柱肿瘤、硬膜外肿瘤和髓内硬膜外肿瘤手术的患者。

统计分析方法

确定VTE的发生率及据报道与VTE相关的临床因素,然后用适当的Cox回归模型进行分析。

结果

本研究共纳入103例髓外脊柱肿瘤患者。3例(2.9%)被诊断为近端下肢DVT,未发现有症状的PE。与DVT发生相关的危险因素如下:手术时间≥8小时(风险比[HR]13.98,P = 0.03)和输血(HR 16.38,P = 0.02),而输血是多因素分析后唯一的显著因素(HR 11.77,P = 0.05)。

结论

接受髓外脊柱肿瘤手术的患者DVT发生率为2.9%。输血患者的DVT发生率最高。对于该组患者,应更加关注围手术期相关因素,加强预防并进行早期筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5251/7057870/006fbb61a140/AJNS-15-51-g001.jpg

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