胰腺术后静脉血栓栓塞的危险因素分析  

Risk factors for venous thromboembolism after pancreatic surgery

作　　者：于泽 罗岩 陈华[2] 王刚[2] 孔瑞[2] 谭宏涛[2] 王拥卫[2] 孙备[1] Yu Ze;Luo Yan;Chen Hua;Wang Gang;Kong Rui;Tan Hongtao;Wang Yongwei;Sun Bei(Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Key Laboratory of Hepatosplenic Surgery,Ministry of Education,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院胰胆外科,哈尔滨150001 [2]哈尔滨医科大学附属第一医院肝脾外科教育部重点实验室,哈尔滨150001

出　　处：《中华普通外科杂志》2025年第3期195-200,共6页Chinese Journal of General Surgery

基　　金：国家自然科学基金(82270665,82070658);黑龙江省自然科学基金团队项目(TD2021H001);黑龙江省重点研发计划项目(JD2023SJ42)。

摘　　要：目的探讨胰腺手术患者术后并发静脉血栓栓塞(VTE)的危险因素。方法回顾性分析2016年1月至2024年9月于哈尔滨医科大学附属第一医院接受胰腺切除术的488例患者的临床资料。结果胰腺术后并发VTE患者116例(23.8%)。Logistic分析后筛选出高龄、有腹部手术史、术前高白细胞计数、高血小板淋巴细胞比值(PLR)、接受胰体尾脾切除、开腹手术、中转开腹以及手术时长为胰腺手术后发生VTE的独立危险因素。以上述危险因素构建Nomogram预测模型,ROC曲线下面积为0.781(95%CI:0.731~0.830)。结论具备高龄、既往接受腹部手术、术前白细胞计数与术前PLR比值高、行胰体尾脾切除术、开腹手术、术中中转开腹、手术耗时长这些胰腺术后并发VTE的高危因素的患者应加强VTE防治。Objective To discuss the risk factors for postoperative venous thromboembolism(VTE)in patients undergoing pancreatic surgery.Methods The clinical data of 488 patients who underwent pancreatectomy at the First Affiliated Hospital of Harbin Medical University from Jan 2016 to Sep 2024 was retrospectively analyzed.Results One hundred and sixteen patients(23.8%)developed VTE after pancreatic surgery.Logistic analysis showed that advanced age,abdominal surgery history,high preoperative white blood cell count,high platelet lymphocyte ratio(PLR),distal pancreatectomy with splenectomy,open surgery,conversion to open surgery,and long surgery duration were risk factors.Nomogram prediction model based on the above risk factors was constructed and the area under the ROC curve was subsequently measured to be 0.781(95%CI:0.731-0.830).Conclusion The prevention and control of VTE should be strengthened for patients undergoing pancreatic surgery with advanced age,abdominal surgery history,high preoperative white blood cell count,high PLR,distal pancreatectomy with splenectomy,open surgery,conversion to open surgery,and long surgery duration.

关 键 词：胰腺切除术 静脉血栓栓塞 危险因素 

分 类 号：R73[医药卫生—肿瘤]