[1]王鑫凤,张亚召,于海佳.脑膜瘤术后并发静脉血栓栓塞的危险因素分析[J].中国临床神经外科杂志,2023,28(09):563-565.[doi:10.13798/j.issn.1009-153X.2023.09.005]
　WANG Xin-feng,ZHANG Ya-zhao,YU Hai-jia.Risk factors for venous thromboembolism in patients with meningiomas after microsurgery[J].,2023,28(09):563-565.[doi:10.13798/j.issn.1009-153X.2023.09.005]
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脑膜瘤术后并发静脉血栓栓塞的危险因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年09期
页码:
563-565
栏目:
论著
出版日期:
2023-09-30

文章信息/Info

Title:
Risk factors for venous thromboembolism in patients with meningiomas after microsurgery
文章编号:
1009-153X（2023）09-0563-03
作者:
王鑫凤; 张亚召; 于海佳
053000河北衡水，哈励逊国际和平医院神经外科（王鑫凤、张亚召、于海佳）
Author(s):
WANG Xin-feng;  ZHANG Ya-zhao;  YU Hai-jia
Department of Neurosurgery, Harrison International Peace Hospital, Hengshui053000, China
关键词:
脑膜瘤; 显微手术; 静脉血栓栓塞; 危险因素
Keywords:
Meningiomas;  Microsurgery;  Venous thromboembolism;  Risk factors
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2023.09.005
文献标志码:
A
摘要:
目的 探讨脑膜瘤术后并发静脉血栓栓塞（VTE）的发生率及其危险因素。方法 回顾性分析2018年1月至2022年12月手术治疗的110例脑膜瘤的临床资料。术后2周内进行肺通气/灌注显像（V/Q-Scan）并根据改良肺栓塞诊断前瞻性研究Ⅱ（PIOPED Ⅱ）标准诊断肺栓塞（PE）；进行下肢静脉加压超声（CUS）诊断深静脉血栓形成（DVT）。当符合以下一个或多个标准时，即诊断为VTE：①V/Q-Scan阳性，有/无VTE临床体表现；②V/Q-Scan阴性，但CTA阳性；③CUS阳性，有/无VTE临床表现。结果 110例中，18例（16.4%）术后发生VTE，包括2例出现呼吸困难或胸痛，4例出现下肢肿胀或疼痛，12例无症状；17例Q/V-Scan阳性，1例Q/V-Scan阴性、胸部CTA阳性；2例Q/V-Scan阳性病人诊断为PE，6例下肢CUS诊断为DVT。单因素分析显示，年龄、体重指数、术中出血量、手术时间与术后VTE有关（P<0.05）。多因素logistic回归分析显示，较高的年龄（OR=1.186；95% CI 1.027~1.370；P=0.020）、体质指数（OR=3.300；95% CI 1.371~7.947；P=0.008）是脑膜瘤术后并发VTE的独立危险因素。结论 脑膜瘤术后并发VTE的问题不容忽视，临床需考虑年龄、体质指数等危险因素，制定预防措施，以减少VTE的发生率。
Abstract:
Objective To investigate the incidence and risk factors of venous thromboembolism (VTE) in patients with meningioma after surgery. Methods The clinical data of 110 patients with meningioma who underwent surgery from January 2018 to December 2022 were retrospectively analyzed. Pulmonary ventilation/perfusion imaging (V/Q-Scan) was performed within 2 weeks after surgery and pulmonary embolism (PE) was diagnosed according to the modified prospective study on the diagnosis of pulmonary embolism II (PIOPED II) criteria. Compression venous ultrasonography (CUS) was performed to diagnose deep venous thrombosis (DVT). When one or more of the following criteria were met, VTE was diagnosed: V/Q-Scan positive with/without clinical manifestations of VTE;V/Q-Scan negative but CTA positive; CUS positive with/without clinical manifestations of VTE. Results Of theses 110 patients, 18 patients (16.4%) had VTE after surgery, including 2 with dyspnea or chest pain, 4 with lower limb swelling or pain, and 12 without symptoms;17 with positive Q/V-Scan, 1 with negative Q/V-Scan and positive chest CTA; 2 patients with positive Q/V-Scan were diagnosed with PE, and 6 patients were diagnosed with DVT by CUS. Univariate analysis showed that age, body mass index, intraoperative blood loss, and operation time were associated with postoperative VTE (P<0.05). Multivariate logistic regression analysis showed that higher age (OR=1.186; 95% CI 1.027-11.370; P=0.020) and body mass index (OR=3.300; 95% CI 1.371-7.947; P=0.008) were independent risk factors for VTE in patients with meningoma after surgery. Conclusions The VTE after meningioma surgery should not be ignored. The risk factors such as age and body mass index should be considered in clinical practice to develop preventive measures to reduce the incidence of VTE.

参考文献/References:

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备注/Memo

备注/Memo:
（2023-03-31收稿，2023-07-21修回）
更新日期/Last Update: 2022-09-30