泌尿外科患者围手术期静脉血栓栓塞发病情况分析  

Analysis of the incidence of venous thromboembolic disease in urological inpatients during perioperation

作　　者：徐浩[1] 许盛飞 袁晓奕[1] 屈晓玲 陈文琼 李浩 杨为民[1] Xu Hao;Xu Shengfei;Yuan Xiaoyi;Qu Xiaoling;Chen Wenqiong;Li Hao;Yang Weimin(Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030

出　　处：《中华泌尿外科杂志》2023年第3期195-199,共5页Chinese Journal of Urology

摘　　要：目的探讨泌尿外科住院患者围手术期静脉血栓栓塞(VTE)的发病情况。方法回顾性分析华中科技大学同济医学院附属同济医院泌尿外科2019年1—12月收治的7988例患者的临床资料。男5657例,女2331例;年龄(56.3±15.8)岁,体质量指数(23.8±3.2)kg/m^(2);其中恶性肿瘤1628例,非恶性肿瘤6360例;7725例接受手术治疗。所有患者入院后采用Caprini血栓风险评估量表(2005)进行评分,VTE极低危1655例,低危2940例,中危2922例,高危345例,极高危126例。对于中危及以上患者和/或有临床症状患者行静脉彩色多普勒超声检查;对有胸痛、胸闷、血氧饱和度下降等症状疑似肺栓塞患者,行CT肺动脉造影检查,筛查VTE的发病情况。结果本组7988例中,术前检查发现180例(2.25%,180/7988)VTE,其中1例(0.01%,1/7988)肺栓塞。术后199例新发VTE,术后VTE发生率为2.58%(199/7725),其中7例发现肺栓塞,发生率为0.09%(7/7725)。所有VTE患者中,仅7.92%(30/379)有VTE相关症状。术后VTE发生率较高的手术依次为根治性膀胱切除术、肾输尿管切除术、根治性前列腺切除术、根治性肾切除术,发生率分别为11.61%(13/112)、10.87%(10/92)、8.25%(16/194)、6.16%(22/357)。结论本研究泌尿外科住院患者的VTE发生率远高于目前文献报道的水平,且绝大部分患者为无症状VTE。术后VTE发生率较高的手术为根治性膀胱切除术、肾输尿管切除术、根治性前列腺切除术、根治性肾切除术。对泌尿外科住院患者进行VTE筛查有助于早期干预,降低VTE进展和肺栓塞发生风险。Objective To investigate the incidence of venous thromboembolic disease(VTE)in urological inpatients during perioperation.Methods The clinical data of 7988 inpatients admitted to the Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January to December 2019 were analyzed retrospectively.The cohort included 5657 males and 2331 females.The average age of the enrolled patients was(56.3±15.8)years old,and the body mass index was(23.8±3.2)kg/m^(2).There were 1628 malignant tumors patients and 6360 non-malignant tumors patients in the cohort.Of all the patients,7725 cases received surgical treatment.All patients were scored with the Caprini Risk Assessment Model(2005)after admission and 1655 cases were classified as very low risk,2940 cases were low risk,2922 cases were medium risk,345 cases were high risk and 126 cases were very high risk.Patients with Caprini score≥2 and/or clinical symptoms were examined by venous color Doppler ultrasound.CT pulmonary angiography was performed for patients with chest pain,chest tightness,decreased blood oxygen saturation and other symptoms suspected of pulmonary embolism according to clinical judgment to screen the incidence of VTE.Results Among the 7988 cases,180 cases(2.25%,180/7988)with VTE were found by preoperative examination,including 1 case(0.01%,1/7988)with pulmonary embolism.There were 199 new cases with VTE after operation,and the incidence of new VTE after operation was 2.58%(199/7725).Among them,pulmonary embolism was found in 7 cases,with a incidence of 0.09%(7/7725).Only 7.92%(30/379)of the VTE patients had VTE-related symptoms.The operations with higher incidence of VTE were radical cystectomy,nephroureterectomy,radical prostatectomy and radical nephrectomy,with the incidence of 11.61%(13/112),10.87(10/92),8.25%(16/194)and 6.16%(22/357)respectively.Conclusions The incidence of VTE in hospitalized patients with urinary surgery in this study is much higher than previously reported.Most of the patients wi

关 键 词：静脉血栓栓塞 深静脉血栓 肺栓塞 泌尿外科 围手术期 

分 类 号：R699[医药卫生—泌尿科学]