头颈肿瘤围术期静脉血栓栓塞症防治中国专家共识

doi:10.19438/j.cjoms.2024.01.001

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (1): 1-9.doi: 10.19438/j.cjoms.2024.01.001

头颈肿瘤围术期静脉血栓栓塞症防治中国专家共识

任振虎^1*，陈铭韬^1*，吴汉江²，张胜²，方坤³，谢尚⁴，刘宇⁵，胡传宇⁶，刘冰⁷，李春洁⁸，朱桂全⁸，王成⁹，高洋¹⁰，张晓晨¹，石剑波¹，张永红¹¹，崔明哲¹²，季彤¹³，任国欣¹，王延安¹，陈伟良14，张陈平^1#，何悦^1#，张志愿^1#

1.上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科，上海交通大学口腔医学院，国家口腔医学中心，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所，上海 200011；
2.中南大学湘雅二医院口腔颌面外科，湖南长沙 410011；
3.国家心血管病中心，中国医学科学院阜外医院血管外科，北京 100037；
4.国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔生物材料和数字诊疗装备国家工程研究中心，北京大学口腔医学院·口腔医院口腔颌面外科，北京 100081；
5.浙江大学医学院附属口腔医院口腔颌面外科，浙江杭州 310020；
6.华中科技大学同济医学院附属同济医院口腔颌面外科，湖北武汉 430030；
7.武汉大学口腔医院口腔颌面外科，湖北武汉 430070；
8.国家口腔医学中心，国家口腔疾病临床医学研究中心，口腔疾病防治全国重点实验室，四川大学华西口腔医院头颈肿瘤外科，四川成都 610041；
9.中山大学附属口腔医院口腔颌面外科，广东广州 510055；
10.苏州大学第一附属医院口腔颌面外科，江苏苏州 215000；
11.河南大学淮河医院口腔颌面外科，河南开封 475000；
12.河南省人民医院血管外科，河南郑州 450000；
13.复旦大学附属中山医院口腔颌面外科，上海 200032；
14.中山大学孙逸仙纪念医院口腔颌面外科，广东广州 510120

收稿日期:2023-10-29 修回日期:2023-11-15 出版日期:2024-01-20 发布日期:2024-02-05
通讯作者: 张志愿，E-mail: zhzhy0502@163.com；何悦，E-mail: william5218@126.com；张陈平，E-mail: zhang.chenping@hotmail.com。#共同通信作者
作者简介:任振虎（1986-），男，副主任医师，硕士研究生导师，E-mail: zhenhuren@126.com；陈铭韬（1997-），男，硕士研究生，E-mail: Hawk0520@sjtu.edu.cn。*并列第一作者

Chinese expert consensus on prevention and management of perioperative venous thromboembolism in head and neck cancer patients

REN Zhen-hu¹, CHEN Ming-tao¹, WU Han-jiang², ZHANG Sheng², FANG Kun³, XIE Shang⁴, LIU Yu⁵, HU Chuan-yu⁶, LIU Bing⁷, LI Chun-Jie⁸, ZHU Gui-quan⁸, WANG Cheng⁹, GAO Yang¹⁰, ZHANG Xiao-chen¹, SHI Jian-bo¹, ZHANG Yong-hong¹¹, CUI Ming-zhe¹², JI Tong¹³, REN Guo-xin¹, WANG Yan-an¹, CHEN Wei-liang¹⁴, ZHANG Chen-ping¹, HE Yue¹, ZHANG Zhi-yuan¹

1.Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University. Changsha 410011, Hunan Province;
3. National Center for Cardiovascular Disease; Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences. Beijing 100037;
4. National Center for Stomatology; National Clinical Research Center for Oral Diseases; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices; Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. Beijing 100081;
5. Department of Oral and Maxillofacial Surgery, School of Stomatology, Zhejiang University. Hangzhou 310020, Zhejiang Province;
6. Department of Oral and Maxillofacial Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Wuhan 430030, Hubei Province;
7. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Wuhan University. Wuhan 430070, Hubei Province;
8. National Center for Stomatology; National Clinical Research Center for Oral Diseases; State Key Laboratory of Oral Diseases; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University. Chengdu 610041, Sichuan Province;
9. Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Sun Yat-sen University. Guangzhou 510055, Guangdong Province;
10. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Soochow University. Suzhou 215000, Jiangsu Province;
11. Department of Oral and Maxillofacial Surgery, Huaihe Hospital of Henan University. Kaifeng 475000, Henan Province;
12. Department of Vascular Surgery, Henan Provincial People’s Hospital. Zhengzhou 450000, Henan Province;
13. Department of Oral and Maxillofacial Surgery, Zhongshan Hospital, Fudan University. Shanghai 200032;
14. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital,Sun Yat-sen University. Guangzhou 510120,Guangdong Province, China

Received:2023-10-29 Revised:2023-11-15 Online:2024-01-20 Published:2024-02-05

摘要/Abstract

摘要： 静脉血栓栓塞症（venous thromboembolism, VTE）是外科术后常见并发症和医院内非预期死亡的重要危险因素，也是恶性肿瘤患者的第二大死亡原因。晚期头颈部恶性肿瘤患者通常需要接受大范围的肿瘤根治手术和同期修复重建手术，又由于高龄兼长时间手术、术后长时间卧床以及肿瘤和化疗药物导致的血液高凝状态等多种危险因素，提示头颈部恶性肿瘤患者应是VTE的极高危群体，但相关文献对头颈部恶性肿瘤患者的VTE发生情况却很少关注，有关VTE在头颈肿瘤术后发生率的数据也有限。迄今为止，国内对于头颈肿瘤围术期静脉血栓栓塞症缺乏相关治疗共识或指南，不同单位对于头颈肿瘤围术期静脉血栓栓塞症的预防与管理水平参差不齐，缺乏统一、科学的诊疗标准及客观的预防与管理评价体系。为统一和规范头颈肿瘤围术期静脉血栓栓塞症的诊治，减少医疗资源浪费，提高治疗效果，国内该研究领域的专家经反复讨论，汇集全国14家著名医学院校及附属医院专家的诊治意见，同时借鉴和参考国内外近年来对头颈肿瘤围术期静脉血栓栓塞症的研究成果与诊治经验，制订本专家共识，供相关临床医师参考。

关键词: 静脉血栓栓塞症, 肺栓塞, 头颈肿瘤, 专家共识

Abstract: Venous thromboembolism (VTE) is a common complication after surgical procedures, and an important risk factor for unexpected death in hospitals, and the second leading cause of death for tumor patients. Patients with advanced head and neck cancer usually require extensive radical surgery and simultaneous repair and reconstruction surgery, and have many risk factors such as elderly, long surgical time, long postoperative bed rest, and hypercoagulable state caused by tumor and chemotherapy drugs, which suggest that patients with head and neck cancer should be an extremely high risk group for VTE. However, little attention has been paid to the occurrence of VTE in patients with cancer in the head and neck, and the data on the incidence of VTE after head and neck cancer surgery are also limited. So far, there is a lack of relevant treatment consensus or guidelines for perioperative VTE of head and neck cancer in China. The level of prevention and management of perioperative VTE of head and neck cancer varies among different institutions, and there is a lack of unified and scientific diagnosis and treatment standards and objective evaluation system for prevention and management. In order to unify and standardize the diagnosis and treatment of perioperative VTE in head and neck cancer, reduce the waste of medical resources and improve the treatment effectiveness, domestic experts in this field have repeatedly discussed the diagnosis and treatment opinions from 14 famous medical institutions in China. This article refers to the research results and diagnosis and treatment experience of perioperative VTE in head and neck cancer world wide in recent years, and formulates this expert consensus for reference by relevant clinicians.

Key words: Venous thromboembolism, Pulmonary embolism, Head and neck tumor, Expert consensus

中图分类号:

R739.8

任振虎，陈铭韬，吴汉江，张胜，方坤，谢尚，刘宇，胡传宇，刘冰，李春洁，朱桂全，王成，高洋，张晓晨，石剑波，张永红，崔明哲，季彤，任国欣，王延安，陈伟良，张陈平，何悦，张志愿. 头颈肿瘤围术期静脉血栓栓塞症防治中国专家共识[J]. 中国口腔颌面外科杂志, 2024, 22(1): 1-9.

REN Zhen-hu, CHEN Ming-tao, WU Han-jiang, ZHANG Sheng, FANG Kun, XIE Shang4, LIU Yu, HU Chuan-yu6, LIU Bing, LI Chun-Jie, ZHU Gui-quan, WANG Cheng, GAO Yang, ZHANG Xiao-chen, SHI Jian-bo, ZHANG Yong-hong, CUI Ming-zhe, JI Tong, REN Guo-xin, WANG Yan-an, CHEN Wei-liang, ZHANG Chen-ping, HE Yue, ZHANG Zhi-yuan. Chinese expert consensus on prevention and management of perioperative venous thromboembolism in head and neck cancer patients[J]. China J Oral Maxillofac Surg, 2024, 22(1): 1-9.

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头颈肿瘤围术期静脉血栓栓塞症防治中国专家共识

Chinese expert consensus on prevention and management of perioperative venous thromboembolism in head and neck cancer patients

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