Xiao Jian, Song Yexun, Tan Guolin
Department of Otolaryngology Head and Neck Surgery，Third Xiangya Hospital of Central South University，Changsha，410013，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep;35(9):779-783. doi: 10.13201/j.issn.2096-7993.2021.09.003.
To investigate the incidence, risk factors, prevention and treatment of venous thromboembolism（VTE） after head and neck malignant tumor surgery. From February 2014 to February 2020, a total of 889 patients with head and neck malignant tumor treated in the Department of Otolaryngology Head and Neck Surgery of the Third Xiangya Hospital of Central South University were selected as the research objects. 16 patients with VTE were selected as the observation group, and 30 patients were randomly selected as the control group from 873 patients without VTE. The related evaluation indexes were analyzed by univariate and multivariate logistic regression. ①VTE occurred in 16 cases of 889 patients with head and neck malignancy, and the incidence of VET in head and neck malignant tumor patients was 1.80%. ② Univariate analysis showed that postoperative VTE was related to gender, age, BMI, preoperative PICC, operation time and bed rest time. Multivariate logistic regression analysis indicated that age≥60 years old（=0.087, 95%: 0.012-0.643）, preoperative PICC（=0.133, 95% 0.021-0.856） and operation time≥3 h（0.119, 95% 0.016-0.889） was an independent risk factor of VTE after head and neck malignant tumor operation （<0.05）. VTE is a serious complication after operation for head and neck malignant tumor. The risk factors of postoperative VTE include age≥60 years, preoperative PICC and operation time≥3 h. Early prevention and timely treatment are the key to reduce postoperative VTE mortality.
探讨头颈部恶性肿瘤手术后静脉血栓栓塞症（VTE）的发生率、危险因素、预防及治疗方法。选取2014年2月至2020年2月在中南大学湘雅三医院耳鼻咽喉头颈外科治疗的889例头颈部恶性肿瘤患者作为研究对象。选取16例发生VTE的患者作为观察组，从873例未发生VTE的患者中随机选取30例作为对照组。采用单因素和多因素logistic回归分析相关评估指标。①889例头颈部恶性肿瘤患者中，16例发生VTE，头颈部恶性肿瘤患者VET发生率为1.80%。②单因素分析显示，术后VTE与性别、年龄、BMI、术前PICC、手术时间及卧床时间有关。多因素logistic回归分析表明，年龄≥60岁（=0.087，95%：0.012 - 0.643）、术前PICC（=0.133，95% 0.021 - 0.856）及手术时间≥3 h（0.119，95% 0.016 - 0.889）是头颈部恶性肿瘤手术后VTE的独立危险因素（<0.05）。VTE是头颈部恶性肿瘤手术后的严重并发症。术后VTE的危险因素包括年龄≥60岁、术前PICC及手术时间≥3 h。早期预防和及时治疗是降低术后VTE死亡率的关键。
