【摘要】：目的探討婦科惡性腫瘤手術(shù)患者并發(fā)靜脈血栓栓塞癥(VTE)的危險(xiǎn)因素,并評(píng)價(jià)《住院患者靜脈血栓栓塞癥風(fēng)險(xiǎn)評(píng)估表》在婦科惡性腫瘤手術(shù)并發(fā)VTE患者中的應(yīng)用價(jià)值。方法選取我院2010年10月至2015年11月期間收治的婦科惡性腫瘤手術(shù)患者530例,其中確診并發(fā)VTE者58例,未并發(fā)VTE者472例,根據(jù)患者年齡、體質(zhì)量指數(shù)(BMI)、腫瘤類(lèi)型、腫瘤分期、手術(shù)方式、手術(shù)時(shí)長(zhǎng)、出血量、有無(wú)輸血、臥床時(shí)間、有無(wú)合并癥等因素進(jìn)行統(tǒng)計(jì)學(xué)分析。應(yīng)用我院多學(xué)科聯(lián)合制定的新版《住院患者靜脈血栓栓塞癥風(fēng)險(xiǎn)評(píng)估表》對(duì)2015年11月至2017年4月收治的317例婦科惡性腫瘤手術(shù)患者進(jìn)行圍手術(shù)期的動(dòng)態(tài)評(píng)估,根據(jù)評(píng)估結(jié)果采取針對(duì)性的干預(yù)措施,統(tǒng)計(jì)VTE的發(fā)生率并與未應(yīng)用評(píng)估表的患者進(jìn)行比較。結(jié)果單因素分析結(jié)果顯示,婦科惡性腫瘤手術(shù)患者并發(fā)VTE與BMI、腫瘤分期、手術(shù)時(shí)長(zhǎng)、出血量、有無(wú)輸血、臥床時(shí)間有關(guān)(P0.05);多因素分析結(jié)果顯示,年齡、BMI、腫瘤分期、手術(shù)時(shí)長(zhǎng)、手術(shù)方式是影響婦科惡性腫瘤手術(shù)患者并發(fā)VTE的獨(dú)立危險(xiǎn)因素(P0.05)。應(yīng)用新版《住院患者靜脈血栓栓塞癥風(fēng)險(xiǎn)評(píng)估表》進(jìn)行評(píng)估并采取針對(duì)性措施后,VTE的發(fā)生率低于應(yīng)用前[1.89%(6/317)vs 10.9%(58/530)],差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論年齡、BMI、腫瘤分期、手術(shù)時(shí)長(zhǎng)、手術(shù)方式是影響婦科惡性腫瘤手術(shù)患者并發(fā)VTE的獨(dú)立危險(xiǎn)因素。通過(guò)在圍手術(shù)期有效評(píng)估VTE發(fā)生風(fēng)險(xiǎn),根據(jù)風(fēng)險(xiǎn)評(píng)分采取相應(yīng)有效預(yù)防措施,可降低婦科惡性腫瘤手術(shù)患者VTE的發(fā)生率。
[Abstract]:Objective to investigate the risk factors of venous thrombus embolism (VTE) in patients with gynecological malignant tumor and to evaluate the value of venous thrombus risk assessment form in gynecological malignant tumor patients complicated with VTE. Methods from October 2010 to November 2015, 530 patients with gynecological malignant tumors were selected, including 58 patients with VTE and 472 patients without VTE. According to the patient's age and body mass index (BMI), (BMI), tumor type. Tumor stage, operation method, operation time, bleeding volume, blood transfusion, bed rest time, complications and other factors were statistically analyzed. The perioperative dynamic evaluation of 317 patients with gynecological malignant tumor from November 2015 to April 2017 was carried out by using the new version of "risk Assessment form for venous thrombosis of inpatients", which was jointly developed in our hospital. According to the results of the evaluation, the incidence of VTE was counted and compared with that of patients who did not use the evaluation form. Results univariate analysis showed that VTE was related to BMI, tumor stage, long operation time, blood loss, blood transfusion and bed rest time in patients with gynecological malignant tumor (P 0.05). The results of multivariate analysis showed that age, BMI, tumor stage, long operation time and operation mode were independent risk factors for VTE in patients with gynecological malignant tumors (P 0.05). After evaluating the risk assessment form of venous thrombosis in inpatients and taking targeted measures, the incidence of VTE was lower than that before application [1.89% (6 鈮，

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