基于循证的原发性肝癌患者腹腔镜精准肝切除术后VTE危险因素识别与预防策略研究OA
Research on the Identification of VTE Risk Factors and Prevention Strategies in Patients with Primary Liver Cancer after Laparoscopic Precise Hepatectomy Based on Evidence-Based Research
目的:基于循证识别原发性肝癌(PLC)患者腹腔镜精准肝切除术后VTE的危险因素,并据此制定预防策略.方法:选取 2023 年 1 月—2024 年 12 月德阳市人民医院收治的 121 例PLC患者作为研究对象.根据患者是否被诊断为静脉血栓栓塞病(VTE),将患者分为VTE组(32 例)和非VTE组(89 例).基于循证医学思想,参考国内外已发表的相关文献资料进行编制针对PLC患者腹腔镜精准肝切除术后VTE相关因素的专项调查表,并对单因素分析有统计学差异的因素经变量赋值后进行logistic回归分析.结果:体质量指数高、手术时间>240 min、Caprini评分高、卧床时间>48 h、合并门静脉癌栓、术后第 1 d D-二聚体>3 000 μg/L是影响PLC患者腹腔镜精准肝切除术后VTE发生的独立危险因素(OR>1,P<0.05).结论:影响PLC患者腹腔镜精准肝切除术后VTE发生的独立危险因素较多,因此临床应多加关注此类患者,建议早期及时采取以上预防性干预策略,以期降低PLC患者腹腔镜精准肝切除术后VTE发生率.
Objective:Based on evidence-based identification of the risk factors of VTE in patients with primary liver cancer(PLC)after laparoscopic precise hepatectomy,and accordingly formulating prevention strategies.Method:121 patients with PLC admitted to Deyang People's Hospital from January 2023 to December 2024 were selected for the study.According to whether the patients were diagnosed with venous thromboembolism(VTE),they were divided into the VTE group(32 cases)and the non-VTE group(89 cases).Based on the idea of evidence-based medicine and referring to the relevant literature published at home and abroad,a special questionnaire on the related factors of VTE in patients with PLC after laparoscopic precise hepatectomy was compiled.logistic regression analysis was given for the factors with statistical differences in the univariate analysis after variable assignment.Result:High body mass index,operation time>240 min,high Caprini score,bed rest time>48 h,combined portal vein tumor thrombus,and D-dimer>3,000 μg/L on the first day after surgery were independent inducing factors affecting the occurrence of VTE after laparoscopic precise hepatectomy in PLC patients(OR>1,P<0.05).Conclusion:There are many independent risk factors influencing the occurrence of VTE in patients with PLC after laparoscopic precise hepatectomy.Therefore,more attention should be paid to such patients in clinical practice.It is recommended to adopt the above preventive intervention strategies in a timely manner at an early stage in order to reduce the incidence of VTE in patients with PLC after laparoscopic precise hepatectomy.
刘竹;陈香玉;谭洁
德阳市人民医院 四川 德阳 618000德阳市人民医院 四川 德阳 618000德阳市人民医院 四川 德阳 618000
循证原发性肝癌腹腔镜精准肝切除术静脉血栓栓塞病危险因素预防策略
Evidence-basedPrimary liver cancerLaparoscopic precise hepatectomyVenous thromboembolismRisk factorsPreventive strategy
《中外医学研究》 2026 (2)
16-20,5
四川护理职业学院科研基金课题资助(2025ZRY32)
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