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儿科癌症患者手术中深静脉血栓形成的风险。

Risk for deep venous thrombosis in pediatric cancer patients undergoing surgery.

机构信息

Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States.

Department of Hematology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, United States.

出版信息

J Pediatr Surg. 2021 Dec;56(12):2360-2363. doi: 10.1016/j.jpedsurg.2021.01.047. Epub 2021 Feb 13.

Abstract

PURPOSE

Cancer is a well-established risk factor for deep venous thrombosis (DVT). We sought to assess the incidence of DVT in pediatric cancer patients undergoing select surgical procedures at our institution and to identify additional factors associated with DVT development.

METHODS

We performed a retrospective review of cancer patients who underwent select surgical procedures and developed a DVT within 30 days of their operation from 2000 to 2018 at our institution. Catheter-associated DVTs were excluded from this analysis. Major oncologic operations were selected.

RESULTS

From 2000 to 2018, 3031 major oncologic operations were performed following which 14 symptomatic DVTs occurred, for an overall incidence of 0.46%. Procedures associated with post-operative DVT included: mass biopsy (7), pulmonary wedge resection (2), inguinal lymph node excision (1), colectomy (1), nephrectomy (1), lower extremity limb-sparing revision (1), and femur resection (1).

CONCLUSIONS

Our data suggest that surgery does not put children with cancer at significant risk for DVT. Given the low incidence of perioperative DVT, routine pharmacologic prophylaxis for children with cancer undergoing surgery does not seem warranted.

LEVEL OF EVIDENCE

II.

摘要

目的

癌症是深静脉血栓形成(DVT)的既定危险因素。我们旨在评估本机构接受特定手术的儿科癌症患者中 DVT 的发生率,并确定与 DVT 发展相关的其他因素。

方法

我们对 2000 年至 2018 年期间在本机构接受特定手术且术后 30 天内发生 DVT 的癌症患者进行了回顾性研究。本分析排除了与导管相关的 DVT。选择了主要的肿瘤手术。

结果

2000 年至 2018 年期间,进行了 3031 次主要肿瘤手术,随后发生了 14 例有症状的 DVT,总体发生率为 0.46%。与术后 DVT 相关的手术包括:肿块活检(7 例)、肺楔形切除术(2 例)、腹股沟淋巴结切除术(1 例)、结肠切除术(1 例)、肾切除术(1 例)、下肢保肢术(1 例)、股骨切除术(1 例)。

结论

我们的数据表明,手术不会使癌症儿童面临 DVT 的重大风险。鉴于围手术期 DVT 的发生率较低,对于接受手术的癌症儿童,常规使用药物预防似乎没有必要。

证据水平

II 级。

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