宫颈癌患者麻醉术后发生下肢深静脉血栓的影响因素  

Risk factor of lower extremity deep vein thrombosis in cervical cancer patients following anesthesia and surgery

作　　者：汪秋凤 蔡永亮 张庆伟 王忠云 孙合亮 Wang Qiufeng;Cai Yongliang;Zhang Qingwei;Wang Zhongyun;Sun Heliang(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210009,Jiangsu,China;Department of Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210009,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院麻醉与围术期医学科,江苏南京210009 [2]南京医科大学第一附属医院外科,江苏南京210009

出　　处：《血管与腔内血管外科杂志》2025年第3期399-403,共5页Journal of Vascular and Endovascular Surgery

基　　金：国家自然科学基金(82371283);中华国际医学交流基金会中青年医学研究专项基金(Z-2018-35-2002)。

摘　　要：目的探讨宫颈癌患者麻醉术后住院期间发生下肢深静脉血栓(DVT)的影响因素。方法收集2023年3月至2024年6月于南京医科大学第一附属医院接受全身麻醉手术的151例宫颈癌患者的临床资料,按照住院期间是否发生下肢DVT将其分为DVT组(n=29)和对照组(n=122)。比较两组患者术前的临床特征、专科指标、手术过程的主要指标以及术后的干预措施,分析宫颈癌患者麻醉术后住院期间发生下肢DVT的影响因素。结果DVT组患者老年(年龄≥65岁)、腺癌、临床分期Ⅲ~Ⅳ期、手术时间﹥2 h、术中低体温比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,老年、腺癌、临床分期Ⅲ~Ⅳ期、手术时间﹥2 h、术中低体温均是宫颈癌患者麻醉术后住院期间发生下肢DVT的危险因素(P﹤0.05),使用S-氯胺酮是宫颈癌患者麻醉术后住院期间发生下肢DVT的保护因素(P﹤0.05)。结论老年、腺癌、临床分期Ⅲ~Ⅳ期、手术时间﹥2 h、术中低体温均是宫颈癌患者麻醉术后住院期间发生下肢DVT的危险因素,使用S-氯胺酮是宫颈癌患者麻醉术后住院期间发生下肢DVT的保护因素,临床工作中可据此识别发生下肢DVT的高危人群,为优化手术过程中的麻醉管理提供参考依据。Objective To investigate the influencing factor of lower extremity deep vein thrombosis(DVT)in patients with cervical cancer after anesthesia.Method Clinical data of 151 patients with cervical cancer who received general anesthesia in the First Affiliated Hospital of Nanjing Medical University from March 2023 to June 2024 were collected.According to whether lower extremity DVT occurred during hospitalization,they were divided into DVT group(n=29)and control group(n=122).The preoperative clinical features,specialty indexes,main indexes of surgical process and postoperative intervention measures were compared between the two groups,and the influencing factors of lower extremity DVT in patients with cervical cancer during hospitalization after anesthesia were analyzed.Result The proportion of elderly patients(age≥65 years old),adenocarcinoma,clinical stageⅢ-Ⅳ,operation time>2 h and intraoperative hypothermia in DVT group were higher than those in control group,with statistical significance(P<0.05).The results of multivariate analysis showed that old age,adenocarcinoma,clinical stageⅢ-Ⅳ,operation time>2 h,and intraoperative hypothermia were all risk factors for lower extremity DVT during hospitalization after anesthesia in cervical cancer patients(P<0.05),and the use of S-ketamine was protective factor for lower extremity DVT during hospitalization after anesthesia in cervical cancer patients(P<0.05).Conclusion Old age,adenocarcinoma,clinical stageⅢ-Ⅳ,operation time>2 h,and intraoperative hypothermia are all risk factors for lower extremity DVT in patients with cervical cancer after anesthesia during hospitalization.The use of S-ketamine is a protective factor for lower extremity DVT in patients with cervical cancer after anesthesia during hospitalization,which can be used to identify high-risk groups of lower extremity DVT in clinical work.It provides reference for optimizing anesthesia management during operation.

关 键 词：宫颈癌 麻醉 术后 住院期间 深静脉血栓 影响因素 

分 类 号：R543[医药卫生—心血管疾病]