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本文引用的文献

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Venous thrombosis and obesity: from clinical needs to therapeutic challenges.静脉血栓形成与肥胖:从临床需求到治疗挑战
Intern Emerg Med. 2025 Jan;20(1):47-64. doi: 10.1007/s11739-024-03765-7. Epub 2024 Sep 13.
2
Construction and verification of a machine learning-based prediction model of deep vein thrombosis formation after spinal surgery.基于机器学习的脊柱手术后深静脉血栓形成预测模型的构建与验证。
Int J Med Inform. 2024 Dec;192:105609. doi: 10.1016/j.ijmedinf.2024.105609. Epub 2024 Aug 30.
3
Postoperative venous thromboembolism after surgery for locally recurrent rectal cancer.局部复发性直肠癌手术后的术后静脉血栓栓塞症。
BMC Cancer. 2024 Aug 20;24(1):1027. doi: 10.1186/s12885-024-12799-1.
4
Treating cancer-associated venous thromboembolism: A practical approach.治疗癌症相关静脉血栓栓塞症:一种实用方法。
Eur J Cancer. 2024 Sep;209:114263. doi: 10.1016/j.ejca.2024.114263. Epub 2024 Aug 5.
5
Screening and Prophylaxis for Venous Thromboembolism in Pediatric Surgery: A Systematic Review.小儿外科学中静脉血栓栓塞症的筛查与预防:系统评价。
J Pediatr Surg. 2024 Oct;59(10):161585. doi: 10.1016/j.jpedsurg.2024.05.015. Epub 2024 Jun 14.
6
Cancer-associated venous thrombosis in adults (second edition): A British Society for Haematology Guideline.成人癌症相关静脉血栓形成(第二版):英国血液学学会指南
Br J Haematol. 2024 Jul;205(1):71-87. doi: 10.1111/bjh.19414. Epub 2024 Apr 25.
7
Venous Thromboembolism Risk Factors in Women With Obesity Who Undergo Cesarean Delivery.肥胖女性行剖宫产术后静脉血栓栓塞症的危险因素。
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241247203. doi: 10.1177/10760296241247203.
8
Cancer-Associated Thrombosis: Trends in Clinical Features, Treatment, and Outcomes From 2001 to 2020.癌症相关血栓形成:2001年至2020年临床特征、治疗及结局的趋势
JACC CardioOncol. 2023 Nov 15;5(6):758-772. doi: 10.1016/j.jaccao.2023.09.003. eCollection 2023 Dec.
9
Factors related to morbidity and mortality of meningiomas resection‑associated venous thromboembolism (Review).脑膜瘤切除相关静脉血栓栓塞症发病及死亡的相关因素(综述)
Mol Clin Oncol. 2023 Jul 19;19(3):70. doi: 10.3892/mco.2023.2666. eCollection 2023 Sep.
10
Incidence, prevention, risk factors, and prediction of venous thromboembolism in Chinese patients after colorectal cancer surgery: a prospective, multicenter cohort study.中国结直肠癌术后患者静脉血栓栓塞症的发生率、预防、危险因素及预测:一项前瞻性、多中心队列研究。
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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.

DOI:10.4240/wjgs.v17.i8.107967
PMID:40949394
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12427079/
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。