摘要
目的:探讨头颈恶性肿瘤手术后静脉血栓栓塞症(VTE)的发生情况、危险因素及预防治疗。方法:选择中南大学湘雅三医院2014年2月—2020年2月耳鼻咽喉头颈外科收治的889例头颈恶性肿瘤手术患者作为研究对象,以发生VTE的16例患者为观察组,从未发生VTE的873例患者中随机抽取30例作为对照组,对相关评价指标进行单因素及多因素Logistic回归分析。结果:(1)头颈外科恶性肿瘤手术患者889例,发生VET者16例,VTE在头颈恶性肿瘤患者中的发病率为1.80%。(2)单因素分析发现头颈恶性肿瘤术后发生VTE与性别、年龄、BMI、术前深静脉置管(PICC)、手术时间及卧床时间有关;多因素Logistic回归分析提示,年龄≥60岁(OR=0.087,95%CI:0.012~0.643)、术前PICC(OR=0.133,95%CI:0.021~0.856)及手术时间≥3 h(OR=0.119,95%CI:0.016~0.889)是头颈恶性肿瘤术后VTE发生的独立危险因素(P<0.05)。结论:VTE是头颈恶性肿瘤手术后严重的并发症,术后VTE发生的危险因素包括年龄≥60岁、术前PICC及手术时间≥3 h。提前预防和及时治疗是降低术后VTE死亡率的关键。
Objective:To investigate the incidence,risk factors,prevention and treatment of venous thromboembolism(VTE)after head and neck malignant tumor surgery.Methods: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.Results:(1)VTE 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(OR=0.087,95%CI:0.012-0.643),preoperative PICC(OR=0.133,95%CI:0.021-0.856)and operation time≥3 h(OR=0.119,95%CI:0.016-0.889)was an independent risk factor of VTE after head and neck malignant tumor operation(P<0.05).Conclusion: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.
作者
肖剑
宋业勋
谭国林
XIAO Jian;SONG Yexun;TAN Guolin(Department of Otolaryngology Head and Neck Surgery,Third Xiangya Hospital of Central South University,Changsha,410013,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CSCD
北大核心
2021年第9期779-783,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
国家自然科学基金资助项目(No:81702706)。
关键词
头颈部肿瘤
静脉血栓栓塞
危险因素
head and neck neoplasms
venous thromboembolism
risk factors
