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| 结直肠癌患者围术期静脉血栓栓塞症风险筛查与管理路径的应用效果分析 |
| Application of perioperativevenous thromboembolism risk screening and management pathway in patients with colorectal cancer |
| 投稿时间：2020-12-20 |
| DOI：10.3969/j.issn.1000-0399.2021.07.029 |
| 中文关键词: 结直肠癌 围手术期 静脉血栓栓塞症 风险筛查 管理路径 |
| 英文关键词: Colorectal cancer Perioperative Venous thromboembolism Risk screening Management pathway |
| 基金项目:安徽省科技厅公益性技术应用研究联动计划项目（项目编号：1704f0804017） |
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| 中文摘要: |
| 目的 探讨围术期静脉血栓栓塞症风险筛查与管理路径的构建与应用对结直肠癌患者深静脉血栓的预防作用。方法 选取2019年1月至2020年4月在安徽省肿瘤医院行结直肠癌根治术的190例患者为研究对象。基于文献回顾与小组会议形成初稿，选取8名专家进行2轮德尔菲专家咨询，形成终版血栓风险筛查与管理路径。将实施风险筛查和管理路径前（2019年1月~6月）的95例患者设为对照组；实施后（2019年7月~2020年4月）的95例患者设为干预组。比较两组患者术前、术后3天、2周的凝血酶原时间（PT）、血浆纤维蛋白原（FIB）、D-二聚体、血小板计数、深静脉血栓发生率、住院天数及住院费用。结果 对照组术后发生血栓13例（13.69%），多于干预组的4例（4.21%），差异有统计学意义（P<0.05）。两组患者的PT、FIB、血小板计数、D-二聚体水平不同时间点差异有统计学意义（P<0.05）；组间PT、FIB、D-二聚体水平差异有统计学意义（P<0.05）；其中D-二聚体存在干预和时间的交互效应（P<0.05）。干预组住院时间及住院费用均低于对照组，差异有统计学意义（P<0.05）。结论 静脉血栓栓塞症风险筛查与管理路径的应用可有效降低结直肠癌术后患者发生深静脉血栓的风险、缩短住院时间，降低治疗费用。 |
| 英文摘要: |
| Objective To investigate the preventive effect of perioperative venous thromboembolism (VTE) risk screening and management pathway on VTE in patients with colorectal cancer.Methods A total of 190 patients who underwent radical resection of colorectal cancer in a tertiary oncology hospital from January 2019 to April 2020 were selected as the research subjects. Based on the literature review and group meeting, the first draft was formed, and experts were selected for rounds of Delphi expert consultation to form the final thromboembolism risk screening and management pathway. 95 patients before the implementation of the risk screening and management pathway (January 2019 to June 2019) were set as the control group, 95 patients after the implementation (July 2019 to April 2020) were set as the observation group.The prothrombin time (PT), plasma fibrinogen (FIB), D-dimer, platelet count, incidence rate of deep venous thrombosis, length of hospital stay and treatment costs were compared between the two groups before operation and at days and weeks after operation. Results There were 13 cases (13.69%) of postoperative thrombosis in control group and 4 cases (4.21%) in intervention group. The incidence rate in intervention group was lower than that in control group (P<0.05). The levels of PT, FIB and D-dimerwere different among groups (P<0.05). D-dimer had both time effect and interaction effect (P<0.05). The length of stay and treatment cost in intervention group were lower than those in control group, and the difference was statistically significant (P<0.05). Conclusion The application of VTE risk screening and management pathway can effectively reduce the risk of deep venous thrombosis, shorten hospital stay length, and reduce treatment costs in postoperative patients with colorectal cancer. |
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