摘要
目的探讨胃癌患者术后发生下肢深静脉血栓(DVT)的危险因素,为胃癌术后DVT防治提供依据。方法检索2023年4月前PubMed、Embase、Web of Science、Ovid、Scopus和Cochrane library英文数据库以及中国知网、万方、维普、CBMdisc发表的有关胃癌术后DVT危险因素文献,提取的数据采用Revman 5.4.1软件进行Meta分析。结果共纳入15项病例对照试验3456例患者。胃癌患者术后发生DVT的重要危险因素包括性别(OR=1.98,95%CI:1.52~2.58,P<0.00001)、体质指数(SMD=0.36,95%CI:0.10~0.62,P=0.007)、开放手术(OR=1.42,95%CI:1.11~1.82,P=0.0005)、冠心病(OR=2.29,95%CI:1.58~3.34,P<0.0001),而手术时长(SMD=0.00,95%CI:-0.19~0.18,P=0.98)、血小板计数(MD=13.37,95%CI:-5.34~32.07,P=0.16)、高血压(OR=1.21,95%CI:0.97~1.50,P=0.09)及糖尿病(OR=1.33,95%CI:0.58~1.89,P=0.88)的差异无统计学意义,与胃癌术后DVT的发生无关。结论影响胃癌术后DVT发生危险因素较多,其中性别、体质指数、手术方式及相关术前慢性病的存在均是重要危险因素,针对性的预防是降低DVT发生率的关键,可能对减少胃癌术后并发症有益。
Objective Based on the literature search,a Meta-analysis of the data on the factors influencing the postoperative deep venous thrombosis(DVT)in patients after gastric cancer surgery was conducted,to investigate the risk factors for the occurrence of DVT and to provide basis for the prevention and treatment of DVT after gastric cancer surgery.Methods PubMed,Embase,Web of Science,Ovid,Scopus,and Cochrane library English databases and China Knowledge Network(CNKI),Wanfang,CQVip,and CBMdisc were searched,and the search time frame was from the establishment to April 2023.Two evaluators independently extracted data from the included literature and performed a Meta-analysis using Revman 5.4.1 software.Results A total of 15 case controlled trials with 3456 patients were included,and the results showed that important risk factors for the development of DVT in patients with postoperative gastric cancer included gender(higher proportion of men than women)(OR=1.98,95%CI:1.52-2.58,P<0.00001),body mass index(SMD=0.36,95%CI:0.10-0.62,P=0.007),open surgery(OR=1.42,95%CI:1.11-1.82,P=0.0005),coronary artery disease(OR=2.29,95%CI:1.58-3.34,P<0.0001),while length of surgery(SMD=0.00,95%CI:-0.19-0.18,P=0.98),platelet count(MD=13.37,95%CI:-5.34-32.07,P=0.16),hypertension(OR=1.21,95%CI:0.97-1.50,P=0.09)and diabetes mellitus(OR=1.33,95%CI:0.58-1.89,P=0.88)were not statistically significant,which were not associated with the occurrence of postoperative DVT in gastric cancer.Conclusions There are many risk factors affecting the occurrence of DVT after gastric cancer surgery,among which gender,body mass index,surgical methods and the existence of related preoperative chronic diseases are important risk factors.Targeted prevention is the key to reduce the incidence of DVT,which may be beneficial to reduce postoperative complications of gastric cancer.
作者
张再博
王冰雨
焦志凯
檀碧波
Zhang Zaibo;Wang Bingyu;Jiao Zhikai;Tan Bibo(The Third Department of Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Hepatobiliary Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China;Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer of Hebei Province,Shijiazhuang 050011,China)
出处
《中华普通外科学文献（电子版）》
CAS
2023年第6期475-480,共6页
Chinese Archives of General Surgery(Electronic Edition)
基金
河北省科技厅引进国外智力项目(7002011)
河北医科大学“十四五”临床医学创新研究团队支持计划项目(2022LCTD-A13)
河北省卫健委医学科学研究课题项目(20230123)。
关键词
胃癌术后
下肢深静脉血栓
危险因素
META分析
Postoperative gastric cancer
Deep venous thrombosis
Risk factors
Meta-analysis
