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围手术期抗凝治疗可降低接受胃肠道手术患者静脉血栓栓塞的发生率。

Perioperative anticoagulation reduces the incidence of venous thromboembolism in patients undergoing gastrointestinal surgery.

作者信息

Jiang Ying, Wang Jia-Fei

机构信息

Department of Gastrointestinal Surgery, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou 310000, Zhejiang Province, China.

出版信息

World J Gastrointest Surg. 2025 Aug 27;17(8):107967. doi: 10.4240/wjgs.v17.i8.107967.

Abstract

BACKGROUND

The risk and mortality rate of venous thromboembolism (VTE) following gastrointestinal surgery remain high, and the symptoms are atypical. Therefore, it is necessary to identify the risk factors associated with the occurrence of VTE following gastrointestinal surgery and to implement appropriate prevention and treatment measures.

AIM

To assess the efficacy of perioperative anticoagulation for the prevention of postoperative VTE.

METHODS

This retrospective study enrolled 205 patients who underwent gastrointestinal surgery. In the observation group ( = 101), prophylactic anticoagulation was administered hypodermic injection of low-molecular-weight heparin during the perioperative period, whereas the control group ( = 104) only received low-molecular-weight heparin treatment postoperatively. Blood coagulation parameters and the incidence of VTE of the bilateral lower limbs pre- and post-surgery were compared between groups. Postoperative VTE was transformed into a dichotomous variable, and influencing factors were explored using multivariate logistic regression analyses.

RESULTS

On the 7 day postoperatively, the incidence of VTE of the bilateral lower limbs was significantly lower in the observation group than in the control group, as were the D-dimer levels ( < 0.05). At 1 month postoperatively, the incidence of VTE was significantly lower in the observation group than in the control group ( < 0.05). An age ≥ 65 years, a body mass index ≥ 24 kg/m, and malignant diseases of the digestive system were identified as risk factors for the occurrence of postoperative VTE in patients undergoing gastrointestinal surgery.

CONCLUSION

The incidence of VTE in patients who underwent gastrointestinal surgery peaked within 1 week postoperatively. The findings confirmed perioperative anticoagulation can safely and effectively reduce the incidence of postoperative VTE.

摘要

背景

胃肠道手术后静脉血栓栓塞症(VTE)的风险和死亡率仍然很高,且症状不典型。因此,有必要识别胃肠道手术后VTE发生的相关危险因素,并采取适当的预防和治疗措施。

目的

评估围手术期抗凝预防术后VTE的疗效。

方法

本回顾性研究纳入了205例行胃肠道手术的患者。观察组(n = 101)在围手术期皮下注射低分子肝素进行预防性抗凝,而对照组(n = 104)仅在术后接受低分子肝素治疗。比较两组手术前后的凝血参数及双下肢VTE的发生率。将术后VTE转化为二分变量,采用多因素logistic回归分析探讨影响因素。

结果

术后第7天,观察组双下肢VTE发生率及D - 二聚体水平均显著低于对照组(P < 0.05)。术后1个月,观察组VTE发生率显著低于对照组(P < 0.05)。年龄≥65岁、体重指数≥24 kg/m²及消化系统恶性疾病被确定为胃肠道手术患者术后VTE发生的危险因素。

结论

胃肠道手术患者VTE发生率在术后1周内达到峰值。研究结果证实围手术期抗凝可安全有效地降低术后VTE的发生率。

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