Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Obstetrics and Gynecology, Beijing Daxing Hospital, Capital Medical University, Beijing, China.
Bioengineered. 2021 Dec;12(2):9668-9677. doi: 10.1080/21655979.2021.1981755.
Deep vein thrombosis (DVT) is common in patients following gynecological surgery. Coagulation factor VIII (FVIII) is an important part of the human coagulation system, and FVIII:C is a component of FVIII with anticoagulant activity. 800 patients who underwent gynecological surgery were enrolled. General clinical data were harvested, and pre - and postoperative serum FVIII levels were determined. Lower-extremity ultrasound examination and/or postoperative pulmonary angiography were performed. Related data were analyzed statistically. DVT was the first manifestation of venous thromboembolism in all cases. There were a total of 46 cases, and the incidence of DVT was 5.8%. Progression to pulmonary embolism was confirmed in 16 cases, with an incidence of 2.0%. The independent risk factors for DVT after gynecological surgery were postoperative FVIII:C levels (odds ratio [OR] = 1.01), age (OR = 6.57), and operation time ≥3 hours (OR = 2.90) ( < 0.05). When the FVIII:C level was greater than the 75th centile (≥150 IU/dL), the risk of DVT was 2.99 times higher than that below the 25th centile (<100 IU/dL) ( < 0.05). When combined with the risk factor of operation time ≥3 hours, the risk increased to 3.17 times ( = 0.10). When combined with age ≥60 years, the risk was significantly increased, reaching 12.0 times ( < 0.05). Serum FVIII:C levels are an independent risk factor for DVT after gynecological surgery. Higher levels increase the risk of DVT after gynecological surgery, and they may have a dose-dependent relationship. A synergistic effect exists in combination with other risk factors, which further increases the risk.
深静脉血栓形成（DVT）在妇科手术后患者中很常见。凝血因子 VIII（FVIII）是人体凝血系统的重要组成部分，FVIII:C 是具有抗凝活性的 FVIII 的组成部分。纳入 800 例行妇科手术的患者。采集一般临床资料，测定术前和术后血清 FVIII 水平。行下肢超声检查和/或术后肺动脉造影。对相关数据进行统计学分析。所有病例均以静脉血栓栓塞症的首发表现为 DVT，共 46 例，DVT 发生率为 5.8%。确诊进展为肺栓塞 16 例，发生率为 2.0%。妇科手术后 DVT 的独立危险因素为术后 FVIII:C 水平（比值比 [OR] = 1.01）、年龄（OR = 6.57）和手术时间≥3 小时（OR = 2.90）（ < 0.05）。当 FVIII:C 水平大于第 75 百分位数（≥150 IU/dL）时，DVT 的风险是第 25 百分位数（<100 IU/dL）以下的 2.99 倍（ < 0.05）。与手术时间≥3 小时的危险因素相结合，风险增加到 3.17 倍（ = 0.10）。与年龄≥60 岁相结合，风险显著增加，达到 12.0 倍（ < 0.05）。血清 FVIII:C 水平是妇科手术后 DVT 的独立危险因素。较高水平增加妇科手术后 DVT 的风险，且可能存在剂量依赖性关系。与其他危险因素结合存在协同作用，进一步增加风险。
