胃肠道肿瘤围手术期静脉血栓栓塞症危险因素分析
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v7i6.17051
Abstract
静脉血栓栓塞症（venous thromboembolism，VTE）：包括肺血栓栓塞症（pulmonary thromboembolism，PTE）和深静脉血栓形成（deep vein thrombosis，DVT），PTE和DVT是同一疾病不同阶段和不同部位的两种临床表现，二者统称为VTE。PTE是一种严重的术后致死性并发症，约80％的肺栓塞是由DVT所致。普通外科手术患者术后DVT发生率为10%～40% 。VTE目前是恶性肿瘤患者的第二大死因，也是导致患者术后死亡的主要原因之一。VTE的危险因素包括血管壁损伤，血流缓慢和血液高凝状态，免疫异常导致的炎症进一步促进了血栓形成。手术创伤如手术体位，手术时间，腹腔镜手术，手术平均血压，手术麻醉时长及手术失血量等均可能对VTE产生影响。这些危险因素在胃肠道肿瘤患者手术中极为普遍。此外胃肠道肿瘤手术因存在解剖复杂，多个吻合口，合并消化道溃疡等出血风险的复杂情况，其预防和治疗也比较困难。为了针对胃肠道肿瘤患者围手术期VTE这一常见并发症，本文通过手术创伤与VTE形成的病理机制、危险因素及防治策略进行综述，以期为胃肠道肿瘤患者围术期减少VTE的发生率提供文献支持。
Keywords
胃肠道肿瘤；围手术期；静脉血栓栓塞症；下肢静脉血栓形成；病理生理机制
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