湖北省胃肠道肿瘤病人围手术期静脉血栓栓塞症多中心调查及分析  

A multicenter survey of perioperative venous thromboembolism in patients with gastrointestinal tumors in Hubei Province

作　　者：张鹏[1] 熊斌[2] 童仕伦[3] 狄茂军[4] 李恒平 袁又能[6] 张子龙 张永康 陈爱军[9] 孙雄 杜寒松 吴彪[11] 何韵彬[12] 李志红[13] 金炜东 胡晓立[15] 彭家群 吴泉峰 周培华 彭先斌 王征[1] 龙跃平 陶凯雄[1] ZHANG Peng;XIONG Bin;TONG Shi-lun(Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;不详)

机构地区：[1]华中科技大学同济医学院附属协和医院胃肠外科,湖北武汉430022 [2]武汉大学中南医院胃肠外科,湖北武汉430071 [3]武汉大学人民医院胃肠外Ⅰ科,湖北武汉430060 [4]十堰市太和医院(湖北医药学院附属太和医院)胃肠外科,湖北十堰442000 [5]湖北医药学院附属襄阳市第一人民医院普外科,湖北襄阳441000 [6]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)胃肠外科,湖北黄石435_ [7]长江大学附属荆州医院胃肠外科,湖北荆州434020 [8]湖北文理学院附属医院(襄阳市中心医院)普外科,湖北襄阳441021 [9]宜昌市中心人民医院(5峡大学第一临床医学院)胃肠外科,湖北宜昌443003 [10]华中科技大学同济医学院附属武汉市中心医院胃肠外科,湖北武汉430060 [11]武汉市第一医院胃肠外科,湖北武汉430022 [12]黄石市爱康医院,湖北黄石435000 [13]鄂州市中心医院普外二科,湖北鄂州436000 [14]中国人民解放军中部战区总医院普通外科,湖北武汉430070 [15]潜江市中心医院普外一科,湖北潜江433100 [16]湖北医药学院附属随州医院普胸普外科,湖北随州441300 [17]恩施土家族苗族自治州中心医院胃肠外科,湖北恩施445000 [18]湖北医药学院附属东风医院普外科,湖北十堰442000 [19]安陆市普爱医院外科,湖北安陆432600

出　　处：《中国实用外科杂志》2021年第7期774-777,785,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81702386,No.81874184,No.82072736)。

摘　　要：目的调查分析湖北省胃肠道肿瘤病人围手术期静脉血栓栓塞症(VTE)防治现状。方法回顾性分析2019-01-01至2019-12-31湖北省胃肠外科联盟成员医院收治的行手术治疗的胃肠道肿瘤病人VTE防治相关临床资料。结果收集62家医院调查问卷7751份,其中有效问卷共计7474份,有效率96.4%。所有病人中,术前736例(9.8%)接受恰当预防措施,7012例(93.8%)术前行D-二聚体检查,2301例(30.7%)术前行下肢静脉超声检查。术后451例(6.0%)病人接受恰当预防措施。术后6434例(86.1%)病人行D-二聚体检查;1675例(22.2%)行下肢静脉超声检查,其中164例发生下肢深静脉血栓(DVT),20例病人发生肺动脉栓塞(PE),有5例PE病人住院期间死亡。结论当前湖北省胃肠道肿瘤病人围手术期下肢静脉超声检查及恰当预防比例偏低,围手术期VTE规范化防治水平有待提高。Objective To investigate and analyze the current situation of prevention and treatment of venous thromboembolism(VTE)in patients with gastrointestinal tumors in Hubei Province during perioperative period.Methods The clinical data of VTE prevention and treatment of gastrointestinal tumor patients underwent surgery from January 1,2019 to December 31, 2019 in Hubei Gastrointestinal Surgery Union Hospital were collected and analyzed retrospectively.Results A total of 7751 questionnaires were collected from 62 member hospitals,of which 7474 were valid,with an effective rate of 96.4%. In the whole group of patients, 736 cases(9.8%) received prophylaxis as appropriate preventive measures, 7012 cases(93.8%) underwent D-dimer examination and 2301 cases(30.7%)underwent lower extremity venous ultrasound examination before surgery. A total of 451 cases(6.0%) received prophylaxis as appropriate preventive measures after surgery. A total of 6434 cases(86.1%) underwent D-dimer examination;1675 cases(22.2%) underwent lower extremity venous ultrasonography examination after surgery,and deep vein thrombosis(DVT) was found in 164 cases. Pulmonary embolism(PE) occurred in 20 cases and 5 of them died during hospitalization.Conclusion proper prevention of gastrointestinal cancer patients in Hubei Province is underutilizd and the level of standardized prevention and treatment of perioperative VTE in gastrointestinal tumor patients should be further improved.

关 键 词：胃肠道肿瘤 静脉血栓栓塞症 问卷调查 围手术期 

分 类 号：R6[医药卫生—外科学]