[1]李灵玉,邹树芳,刘衍芮,等.脊柱术后早期静脉血栓栓塞危险因素的Meta分析[J].医学信息,2022,35(16):55-62.[doi:10.3969/j.issn.1006-1959.2022.16.012]
 LI Ling-yu,ZOU Shu-fang,LIU Yan-rui,et al.Meta Analysis of Risk Factors for Early Venous Thromboembolism After Spinal Surgery[J].Journal of Medical Information,2022,35(16):55-62.[doi:10.3969/j.issn.1006-1959.2022.16.012]
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脊柱术后早期静脉血栓栓塞危险因素的Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年16期
页码:
55-62
栏目:
论著
出版日期:
2022-08-15

文章信息/Info

Title:
Meta Analysis of Risk Factors for Early Venous Thromboembolism After Spinal Surgery
文章编号:
1006-1959(2022)16-0055-08
作者:
李灵玉邹树芳刘衍芮
(1.西南医科大学护理学院,四川 泸州 646000;2.西南医科大学附属医院内分泌科,四川 泸州 646000)
Author(s):
LI Ling-yuZOU Shu-fangLIU Yan-ruiet al.
(1.Nursing School of Southwest Medical University,Luzhou 646000,Sichuan,China;2.Department of Endocrinology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)
关键词:
脊柱手术静脉血栓栓塞危险因素循证护理
Keywords:
Spinal surgeryVenous thromboembolismRisk factorsEvidence-based nursing
分类号:
R543.6;R687.3
DOI:
10.3969/j.issn.1006-1959.2022.16.012
文献标志码:
A
摘要:
目的 系统评价脊柱术后早期静脉血栓栓塞(VTE)的危险因素。方法 计算机检索PubMed、Web of Science、EMbase、The Cochrane Library、Scopus、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库(WanFang Data)和维普数据库(VIP)中关于脊柱术后早期VTE危险因素的文献,使用RevMan5.4软件进行统计分析。结果 共纳入27篇文献,包含37项危险因素。Meta分析结果显示,高龄[OR=2.95,95%CI(2.31,3.78),P<0.000 01]、BMI较高[OR=1.71,95%CI(1.41,2.08),P<0.000 01]、女性[OR=2.96,95%CI(2.11,4.15),P<0.000 01]、D-二聚体较高[OR=1.93,95%CI(1.52,2.45),P<0.000 01]、输血[OR=2.61,95%CI(1.98,3.45),P<0.000 01]、高血压[OR=3.57,95%CI(2.66,4.78),P<0.000 01]、糖尿病[OR=3.05,95%CI(2.09,4.46),P<0.000 01]、术后卧床时间较长[OR=4.13,95%CI(3.01,5.68),P<0.000 01]为脊柱术后早期并发VTE的危险因素,术后锻炼[OR=0.24,95%CI(0.12,0.47),P<0.0001]为脊柱术后早期VTE的保护因素。结论 高龄、BMI较高、女性、D-二聚体较高、输血、高血压、糖尿病、术后卧床时间较长为脊柱术后早期VTE危险因素,术后锻炼为脊柱术后早期VTE保护因素。
Abstract:
Objective To systematically evaluate the risk factors of early venous thromboembolism (VTE) after spinal surgery.Methods Literature related to the risk factors of early VTE in patients after spinal surgery were retrieved from PubMed,Web of Science, Embase, The Cochrane Library, Scopus, China Biology Medicine disc (CBM), China Knowledge Infrastructure (CNKI), Wanfang Database and VIP Database. RevMan5.4 software was used for Meta analysis.Results A total of 27literature were included, including 37 risk factors.Meta analysis showed that advanced age[OR=2.95,95%CI(2.31,3.78),P<0.000 01],higher BMI[OR=1.71,95%CI(1.41,2.08),P<0.000 01], female[OR=2.96,95%CI(2.11,4.15),P<0.000 01],higher D-Dimer[OR=1.93,95%CI(1.52,2.45),P<0.00001], blood transfusion[OR=2.61,95%CI(1.98,3.45),P<0.000 01], hypertension[OR=3.57,95%CI(2.66,4.78),P<0.000 01], diabetes[OR=3.05,95%CI(2.09,4.46),P<0.000 01], longer postoperative bed rest time[OR=4.13,95%CI(3.01,5.68),P<0.000 01] were risk factors forearly venous thromboembolism in patients undergoing spinal surgery,postoperative exercise[OR=0.24,95%CI(0.12,0.47),P<0.00 01] was a protective factor for early venous thromboembolism in patients undergoing spinal surgery.Conclusion Advanced age, higher BMI, female,higher D-dimer, blood transfusion, hypertension, diabetes, and longer postoperative bed rest time are risk factors for early VTE in patients undergoing spinal surgery, while postoperative exercise is a protective factor.

参考文献/References:

[1]Aizawa T,Kokubun S,Ozawa H,et al.Increasing Incidence of Degenerative Spinal Diseases in Japan during 25 Years: The Registration System of Spinal Surgery in Tohoku University Spine Society[J].Tohoku J Exp Med,2016,238(2):153-163.[2]曾小军.低分子肝素在预防脊柱手术后血栓栓塞并发症中的应用[D].武汉:武汉大学,2018.[3]林庆荣,杨明辉,侯志勇.中国创伤骨科患者围手术期静脉血栓栓塞症预防指南(2021)[J].中华创伤骨科杂志,2021,23(3):185-192.[4]Mosenthal WP,Landy DC,Boyajian HH,et al.Thromboprophylaxis in Spinal Surgery[J].Spine,2018,43(8):e474-e481.[5]Cloney MB,Hopkins B,Dhillon ES,et al.The timing of venous thromboembolic events after spine surgery: a single-center experience with 6869 consecutive patients[J].J Neurosurg Spine,2018,28(1):88-95.[6]Schulman S,Ageno W,Konstantinides SV.Venous thromboembolism: Past, present and future[J].Thromb Haemost,2017,117(7):1219-1229.[7]姚晓光,申勇,张英泽,等.后路腰椎椎间融合术后早期并发深静脉血栓形成的相关因素分析[J].中国脊柱脊髓杂志,2008,18(12):910-914.[8]Li J,Hu S,Yang G,et al.Incidence and risk factors of early deep venous thrombosis after posterior cervical surgery-382 cases report[J].Int J Clin Exp Med,2016,9(3):6789-6794.[9]任志帅.脊柱术后早期并发静脉血栓栓塞症的危险因素分析[D].天津:南开大学,2016.[10]Zhao CM,Zhang Y,Yang SD,et al.Risk Factors for Lower Limb Deep Vein Thrombosis in Patients With Single-Level Lumbar Fusion: A Prospective Study of 710 Cases[J].Clin Appl Thromb Hemost,2018,24(suppl 9):157S-162S.[11]严沫琦.腰椎术后深静脉血栓形成的发病率及危险因素分析[D].苏州:苏州大学,2018.[12]陈向荣,尚春风,寇红伟,等.中老年人脊柱退变性疾病术后下肢深静脉血栓形成的危险因素研究[J].中华实验外科杂志,2019,36(9):1699-1702.[13]王丽倩,贺爱兰,唐红英,等.脊柱手术后并发静脉血栓栓塞症的临床特点及危险因素分析[J].解放军护理杂志,2019,36(12):53-56.[14]Li Q,Yu Z,Chen X,et al.Analysis of risk factors for lower limb deep vein thrombosis in patients after lumbar fusion surgery[J].Pak J Med Sci,2020,37(1):239-243.[15]孙雪娇,张兰君,钱志钢.脊柱外科患者下肢深静脉血栓发生的危险因素分析[J].中国医刊,2020,55(6):658-661.[16]柴巍浩.脊柱术后深静脉血栓形成的危险因素分析[D].乌鲁木齐:新疆医科大学,2021.[17]何杏贤,卢向莉,谢水群,等.脊柱骨折手术病人术后深静脉血栓形成危险因素及防控护理分析[J].全科护理,2021,19(16):2167-2170.[18]Wang HY,Pei H,Ding W,et al.Risk factors of postoperative deep vein thrombosis (DVT) under low molecular weight heparin (LMWH) prophylaxis in patients with thoracolumbar fractures caused by high-energy injuries[J].J Thromb Thrombolysis,2021,51(2):397-404.[19]Zhang SX,Shen GJ,Luo MX,et al.Analysis of Related Influencing Factors of Deep Vein Thrombosis after Lumbar Internal Fixation and Treatment Strategy[J].Evid Based Complement Alternat Med,2021,2021:9693012.[20]Yoshioka K,Murakami H,Demura S,et al.Prevalence and risk factors for development of venous thromboembolism after degenerative spinal surgery[J].Spine,2015,40(5):e301-e306.[21]Ikeda T,Miyamoto H,Hashimoto K,et al.Predictable factors of deep venous thrombosis in patients undergoing spine surgery[J].J Orthop Sci,2017,22(2):197-200.[22]Kim BD,Hsu WK,De Oliveira GS,et al.Operative duration as an independent risk factor for postoperative complications in single-level lumbar fusion: An analysis of 4588 surgical cases[J].Spine,2014,39(6):510-520.[23]Wang TY,Sakamoto JT,Nayar G,et al.Independent predictors of 30-day perioperative deep vein thrombosis in 1346 consecutive patients after spine surgery[J].World Neurosurg,2015,84(6):1605-1612.[24]Kalakoti P,Missios S,Maiti T,et al.Inpatient Outcomes and Postoperative Complications After Primary Versus Revision Lumbar Spinal Fusion Surgeries for Degenerative Lumbar Disc Disease: A National (Nationwide) Inpatient Sample Analysis, 2002-2011[J].World Neurosurg,2016,85:114-124.[25]Johnson DJ,Johnson CC,Cohen DB,et al.Thrombotic and Infectious Morbidity Are Associated with Transfusion in Posterior Spine Fusion[J].Hss J,2017,13(2):152-158.[26]Phan K,Kothari P,Lee NJ,et al.Impact of Obesity on Outcomes in Adults Undergoing Elective Posterior Cervical Fusion[J].Spine,2017,42(4):e261-e266.[27]Shin JI,Phan K,Kothari P,et al.Impact of Glycemic Control on Morbidity and Mortality in Adult Idiopathic Scoliosis Patients Undergoing Spinal Fusion[J].Clin Spine Surg,2017,30(7):e974-e980.[28]Zeeshan M,Khan M,O’keeffe T,et al.Optimal timing of initiation of thromboprophylaxis in spine trauma managed operatively: A nationwide propensity-matched analysis of trauma quality improvement program[J].J Trauma Acute Care Surg,2018,85(2):387-392.[29]Cheung ZB,Vig KS,White SJW,et al.Impact of Obesity on Surgical Outcomes Following Laminectomy for Spinal Metastases[J].Global Spine J,2019,9(3):254-259.[30]Katz AD,Mancini N,Karukonda T,et al.Comparative and Predictor Analysis of 30-day Readmission, Reoperation, and Morbidity in Patients Undergoing Multilevel ACDF Versus Single and Multilevel ACCF Using the ACS-NSQIP Dataset[J].Spine,2019,44(23):e1379-e1387.[31]Katz AD,Mancini N,Karukonda T,et al.Approach-based Comparative and Predictor Analysis of 30-day Readmission, Reoperation, and Morbidity in Patients Undergoing Lumbar Interbody Fusion Using the ACS-NSQIP Dataset[J].Spine,2019,44(6):432-441.[32]White SJW,Ranson WA,Cho B,et al.The Effects of Preoperative Steroid Therapy on Perioperative Morbidity and Mortality After Adult Spinal Deformity Surgery[J].Spine Deform,2019,7(5):779-787.[33]De La Garza Ramos R,Gelfand Y,Benton JA,et al.Rates, Risk Factors, and Complications of Red Blood Cell Transfusion in Metastatic Spinal Tumor Surgery: An Analysis of a Prospective Multicenter Surgical Database[J].World Neurosurg,2020,139:e308-e315.[34]Heit JA.Epidemiology of venous thromboembolism[J].Nat Rev Cardiol,2015,12(8):464-474.[35]Xu A,Sibai H,Atenafu EG,et al.Universal venous thromboembolism policy is effective but may not adequately protect hospitalized cancer patients with larger BMI[J].J Thromb Thrombolysis,2020,49(1):113-120.[36]朱凤磊,刘新峰.炎症介质与血栓形成和凝血的关系[J].中国动脉硬化杂志,2008,16(10):838-840.[37]Lorenzet R,Napoleone E,Cutrone A,et al.Thrombosis and obesity: cellular bases[J].Thromb Res,2012,129(3):285-289.[38]Abou-Ismail MY,Citla Sridhar D,Nayak L.Estrogen and thrombosis: A bench to bedside review[J].Thromb Res,2020,192:40-51.[39]Kalaitzopoulos DR,Panagopoulos A,Samant S,et al.Management of venous thromboembolism in pregnancy[J].Thromb Res,2022,211:106-113.[40]Buchanan IA,Lin M,Donoho DA,et al.Venous Thromboembolism After Degenerative Spine Surgery: A Nationwide Readmissions Database Analysis[J].World Neurosurg,2019,125:e165-e174.[41]Cohen AT,Spiro TE,Spyropoulos AC,et al.D-dimer as a predictor of venous thromboembolism in acutely ill, hospitalized patients: a subanalysis of the randomized controlled MAGELLAN trial[J].J Thromb Haemost,2014,12(4):479-487.[42]张玥,亓雪,刘湘,等.血小板参数、纤维蛋白原和D-二聚体对深静脉血栓形成的诊断价值[J].解放军医学杂志,2021,46(9):906-911.[43]Goel R,Patel EU,Cushing MM,et al.Association of Perioperative Red Blood Cell Transfusions With Venous Thromboembolism in a North American Registry[J].JAMA Surg,2018,153(9):826-833.[44]Lee JS,Gladwin MT.Bad blood: the risks of red cell storage[J].Nat Med,2010,16(4):381-382.[45]Liu SK,Song YL,Ding WY,et al.The effect of systematic lower-limb rehabilitation training in elderly patients undergoing lumbar fusion surgery: a retrospective study[J].Oncotarget,2017,8(68):112720-112726.

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更新日期/Last Update: 1900-01-01