目的 分析妇科恶性肿瘤患者围手术期管理与并发静脉血栓栓塞症 (VTE) 的相互关系, 进一步指导临床决策.方法 选择妇科恶性肿瘤围手术期确诊为VTE的患者46例, 并以同期行手术治疗的妇科恶性肿瘤非VTE患者138例为对照, 进行回顾性病例对照分析, 分析临床实践中的VTE相关危险因素及VTE防治策略的有效性及安全性.结果 VTE组患者Caprini评分明显高于非VTE组[ (7.6±2.2) 分vs (5.9±1.6) 分, P＜0.001].具有高危因素的卵巢癌患者更易发生VTE, 其次为子宫体癌, 然后为宫颈癌.围手术期短时间止血药的使用并不增加VTE风险.预防性抗凝药物的使用及双下肢气压治疗可有效预防VTE发生.结论 Caprini风险评估模型对于预测妇科恶性肿瘤患者VTE发生有一定临床意义.常规围手术期管理策略对预防VTE有一定的作用, 但管理策略仍需进一步优化.%Objective To analyze the correlation between the management during the perioperative period and venous thromboembolism of patients with malignant tumors in the department of gynecology thus further guiding the clinical decision-making. Methods 46 cases of VTE patients confirmed with malignant tumors in the department of gynecology in our hospital were selected, while 138 cases of patients with non-VTE treated at the same period were selected as the control group, and the VTE related risk factors and effectiveness and safety of VET prevention strategies were analyzed. Results The Caprini scores in the VTE group were obviously higher than those in the patients with non-VTE group[ (7.6±2.2) points vs (5.9±1.6) points, P＜0.001], and the patients with high-risk oophoroma were easy to suffer from VTE, corpus carcinoma and cervical carcinoma, and the use of short-time hemostatics during the perioperative period did not increase the VTE risk, and the use of preventive anticoagulants and lower extremity barometric pressure treatment can effectively prevent the occurrence of VTE. Conclusion The evaluation model of Caprini risks is of a certain significance to predicting the occurrence of VTE of patients with malignant tumors in the department of gynecology, and the routine management strategies during the perioperative period plays a certain role to prevention of VTE, but the management strategies need to be further optimized.
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