根治性膀胱切除术后静脉血栓栓塞发生情况及影响因素分析OA

Objective To explore the occurrence and influencing factors of venous thromboembolism(VTE)after radical cystectomy(RC).Methods A total of 121 patients who underwent RC at the First Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2024 were selected and divided into non-VTE group(n=61)and VTE group(n=60)based on whether VTE occurred after the surgery.Univariate and multivariate analyses were used to explore the influencing factors of VTE after RC surgery.Results The incidence of VTE after RC was 49.6%(60/121).Among VTE cases,isolated distal deep vein thrombosis of the lower extremities accounted for 90.0%(54/60).There were statistically significant differences between two groups of patients in age,preoperative lower extremity arteriosclerosis,preoperative hemoglobin,preoperative thromboelastography(R-time,K-time,α angle),surgical methods and preoperative blood potassium(P<0.05).The results of multivariate analysis showed that the prolonged R-time of preoperative thromboelastography(OR=0.588,P<0.05)was a protective factor for VTE after RC,while robot-assisted laparoscopic surgery(OR=5.753,P<0.05)and laparoscopic surgery(OR=2.345,P<0.05)were independent risk factors for VTE after RC.Conclusion After RC surgery,VTE is mainly isolated distal deep vein thrombosis of the lower extremities.Preoperative thromboelastogram parameters have certain predictive value.Minimally invasive surgery may increase the risk of VTE by increasing the hypercoagulable state of the blood,which requires clinical attention.