Clinical analysis of 8 cases of venous thromboembolism after spinal surgery
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摘要: 目的 分析脊柱手术后并发静脉血栓栓塞症(VTE)患者的临床资料,探讨其诊断与防治方法。 方法 对宁波大学医学院附属医院脊柱外科于2010年1月-2017年12月收治的8例脊柱手术后并发VTE患者的临床表现、诊断方法、治疗过程及转归等资料进行回顾性分析,结合VTE防治的相关文献,对脊柱手术后并发VTE的流行病学、防治措施进行详细阐述。 结果 本组脊柱手术后并发VTE共8例,其中4例为单纯症状性深静脉血栓(DVT),1例为单纯症状性肺血栓栓塞症(PTE),3例为症状性PTE合并无症状性DVT,VTE总的发生率为0.47%(8/1 699)。4例单纯症状性DVT患者经抗凝及取栓、溶栓、下腔静脉滤网(IVCF)植入术等积极治疗,均治愈出院。4例PTE患者中,有1例为致死性PTE患者,经抢救无效死亡,其余3例经溶栓、抗凝等积极治疗,均治愈出院。 结论 虽然脊柱手术后VTE的发生率较低,但一旦发生后果严重,因此,应务必提高脊柱手术后VTE的预防意识,完善术前的危险因素评估,建立和完善VTE的防治体系,并进一步深化研究,改进脊柱手术VTE风险评估及分级预防模型,以便为今后脊柱手术VTE预防提供理论依据。Abstract: Objective To analyze the clinical data of patients with venous thromboembolism (VTE) after spine surgery, and discuss the diagnosis and treatment. Methods A retrospective analysis was performed on the clinical manifestations, diagnosis methods, treatment processes, and outcomes, which involved 8 cases of VTE after spinal surgery, who received theraphy at the department of spinal surgery of the Affiliated Hospital of Medical School of Ningbo University from January 2010 to December 2017. Combined with the relevant literature on VTE prevention, the epidemiology and prophylactico-therapeutic measures of VTE after spinal surgery were elaborated. Results In this group, there were 8 patients who suffered VTE after spinal surgery. Among these patients, 4 cases suffered single symptomatic deep venous thrombosis (DVT), and 1 case suffered single symptomatic pulmonary thromboembolism (PTE), while the other 3 cases suffered symptomatic PTE and asymptomatic DVT. The overall incidence of VTE was 0.47% (8/1 699). Four patients with symptomatic DVT were cured and discharged after anticoagulation, thrombectomy, thrombolysis, and inferior vena cava filter implantation. Of the 4 patients with PTE, 1 patient was died because of fatal PTE, and the other 3 patients were cured and discharged after thrombolysis and anticoagulation. Conclusion Although the incidence of VTE after spinal surgery is relatively low, once it happens, the consequences are serious. Therefore, it is necessary to increase the awareness of prevention of VTE, improve preoperative assessment of risk factors, and establish VTE prevention and control systems. The risk assessment and graded prevention model of VTE after spine surgery should be improve in order to provide theoretical basis for the VTE prevention in the future.
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Key words:
- Surgery /
- Spine /
- Complication /
- Venous thromboembolism
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