口腔癌老年患者术后静脉血栓栓塞症的危险因素分析

doi:10.19438/j.cjoms.2024.03.005

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (3): 233-238.doi: 10.19438/j.cjoms.2024.03.005

口腔癌老年患者术后静脉血栓栓塞症的危险因素分析

洪磊¹, 陈伟良²

1.广州市第一人民医院口腔科,广东广州 510180;
2.中山大学孙逸仙纪念医院口腔颌面外科,广东广州 510030

收稿日期:2023-11-15 修回日期:2023-12-23 出版日期:2024-05-20 发布日期:2024-06-11
通讯作者: 陈伟良,E-mail: drchen@vip.163.com
作者简介:洪磊（1993-）,男,硕士,E-mail: hongsanshi1993@163.com
基金资助:
国家自然科学基金（81772888）

Risk factor analysis of postoperative venous thromboembolism in elderly patients with oral cancer

HONG Lei¹, CHEN Wei-liang²

1. Department of Stomatology, Guangzhou First People's Hospital. Guangzhou 510180;
2. Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University. Guangzhou 510030, Guangdong Province, China

Received:2023-11-15 Revised:2023-12-23 Online:2024-05-20 Published:2024-06-11

摘要/Abstract

摘要： 目的：探讨口腔癌老年患者术后发生静脉血栓栓塞症（venous thromboembolism, VTE）的危险因素。方法：对2016年10月至2021年10月在中山大学孙逸仙纪念医院口腔颌面外科接受治疗的219例老年口腔癌患者术后发生VTE的相关危险因素进行评估。采用SPSS 25.0软件包中的单因素和多因素logistic回归分析筛选老年口腔癌患者术后发生VTE的危险因素。结果：219例患者中,55例术后发生VTE,占25.11%。单因素分析表明,年龄、性别、HGB、FIB、D二聚体、手术时间以及术后是否使用低分子肝素钠与患者术后VTE的发生相关（P<0.05）。多因素logistic回归分析显示,年龄>70岁、女性患者以及手术时间>340 min是术后发生VTE的危险因素,预防性使用低分子肝素钠可降低VTE发生风险。结论：年龄和手术时间是老年口腔癌患者术后发生VTE的独立危险因素。对于无抗凝禁忌证的患者,术后预防性使用低分子肝素钠可以显著降低VTE的发生率。对于年龄>70岁、手术时间>340 min的女性患者,应采取必要的术后VTE预防措施。

关键词: 静脉血栓栓塞症, 口腔癌, 老年, 修复重建, 危险因素

Abstract: PURPOSE: To investigate the risk factors of postoperative venous thromboembolism(VTE) in elderly patients with oral cancer. METHODS: Retrospective collection and evaluation of the relevant risk factors for postoperative VTE in 219 elderly patients undergoing oral cancer treatment at Sun Yat-sen Memorial Hospital of Sun Yat-sen University from October 2016 to October 2021 were conducted. A total of 219 cases were included, and both univariate and multivariate logistic regression analysis were used to identify the risk factors for postoperative VTE in elderly oral cancer patients with SPSS 25.0 software package. RESULTS: Among the 219 patients, 55 developed VTE after surgery, accounting for 25.11%. Univariate analysis indicated that age, gender, hemoglobin(HGB), fibrinogen(FIB), D-dimer, surgical duration, and postoperative use of low molecular weight heparin (LMWH) were significantly associated with postoperative VTE (P<0.05). Multivariate logistic regression analysis revealed that age >70 years, female gender, and surgical duration >340 min were risk factors for postoperative VTE. Prophylactic use of LMWH was found to reduce the risk of VTE. CONCLUSIONS: Patients' age and surgical duration are independent risk factors for postoperative VTE in elderly patients with oral cancer. For patients without contraindications to anticoagulation, postoperative prophylactic use of LMWH can significantly reduce the incidence of VTE. Necessary postoperative VTE prevention measures should be taken for female patients over 70 years of age with surgical durations exceeding 340 min.

Key words: Venous thromboembolism, Oral cancer, Elderly, Reconstructive surgery, Risk factors

中图分类号:

R739.8

洪磊, 陈伟良. 口腔癌老年患者术后静脉血栓栓塞症的危险因素分析[J]. 中国口腔颌面外科杂志, 2024, 22(3): 233-238.

HONG Lei, CHEN Wei-liang. Risk factor analysis of postoperative venous thromboembolism in elderly patients with oral cancer[J]. China J Oral Maxillofac Surg, 2024, 22(3): 233-238.

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口腔癌老年患者术后静脉血栓栓塞症的危险因素分析

Risk factor analysis of postoperative venous thromboembolism in elderly patients with oral cancer

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