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术后颅骨切开术治疗胶质瘤患者深静脉血栓形成的发生率及术前、术中预后因素。

Incidence, and preoperative and intraoperative prognostic factors of deep venous thrombosis in patients with glioma following craniotomy.

机构信息

Department of Critical Care Medicine, Capital Medical University Affiliated Beijing Shijitan Hospital, 100038, Beijing, China.

Department of General practice medicine, Beijing Shijingshan Hospital, 100040, Beijing, China.

出版信息

Clin Neurol Neurosurg. 2021 Nov;210:106998. doi: 10.1016/j.clineuro.2021.106998. Epub 2021 Oct 22.

Abstract

OBJECTIVES

The aim of this study was to investigate the incidence of deep vein thrombosis (DVT) and the preoperative and intraoperative risk factors associated with DVT in glioma patients METHODS: We conducted a retrospective analysis of data obtained from glioma patients at Sanbo Hospital (Beijing, China) between 2018 and 2021. Symptomatic DVT was confirmed by Doppler ultrasonography. Multivariable logistic regression analysis was used to identify preoperative and intraoperative characteristics associated with DVT. Basic clinical variables and laboratory results were analyzed.

RESULTS

A total of 492 glioma patients were included. Of these, 73 (14.84%) developed DVT, and three (0.61%) developed DVT and pulmonary embolism (PE). Multivariate analyses revealed that the following factors were highly predictive of post-operative DVT: older age ranges of 46--55 years (odds ratio [OR]: 2.94; 95% confidence interval [CI]: 1.41--6.13; p = 0.004), 56--65 years (OR: 7.86; 95% CI: 3.63--17.03; p < 0.001), and > 65 years (OR: 4.94; 95% CI: 1.83--13.33; p = 0.002); partial thromboplastin time (APTT; OR: 0.91; 95% CI: 0.84--1.00; p = 0.040); D-dimer (OR: 2.21; 95% CI: 1.28--3.82; p = 0.005); and surgery duration (OR: 2.87; 95% CI: 1.6 --5.07; p < 0.001) CONCLUSIONS: Older age, preoperative APTT, D-dimer, and surgery duration independently increased the risk of developing postoperative DVT. These findings may facilitate the development of a thrombosis risk score that will allow physicians to develop individualized strategies to prevent DVT as early as possible.

摘要

目的

本研究旨在调查脑肿瘤患者深静脉血栓形成(DVT)的发生率以及与 DVT 相关的术前和术中危险因素。

方法

我们对 2018 年至 2021 年在北京三博脑科医院就诊的脑肿瘤患者的数据进行了回顾性分析。通过多普勒超声检查确诊症状性 DVT。采用多变量 logistic 回归分析确定与 DVT 相关的术前和术中特征。分析了基本临床变量和实验室结果。

结果

共纳入 492 例脑肿瘤患者,其中 73 例(14.84%)发生 DVT,3 例(0.61%)发生 DVT 和肺栓塞(PE)。多变量分析显示,以下因素高度预测术后 DVT:年龄在 46-55 岁之间(比值比[OR]:2.94;95%置信区间[CI]:1.41-6.13;p=0.004)、56-65 岁(OR:7.86;95%CI:3.63-17.03;p<0.001)和>65 岁(OR:4.94;95%CI:1.83-13.33;p=0.002);部分凝血活酶时间(APTT;OR:0.91;95%CI:0.84-1.00;p=0.040);D-二聚体(OR:2.21;95%CI:1.28-3.82;p=0.005);手术时间(OR:2.87;95%CI:1.6-5.07;p<0.001)。

结论

年龄较大、术前 APTT、D-二聚体和手术时间独立增加了术后发生 DVT 的风险。这些发现可能有助于开发血栓形成风险评分,使医生能够尽早制定个体化策略来预防 DVT。

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