中国实用外科杂志

中国实用外科杂志

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我国成年人腹股沟疝围手术期静脉血栓栓塞症发生率和相关因素现状调查（CHAT-1）

王明刚1，李航宇2，张光永3，李健文4，陈    杰1 ，唐健雄5，车    焱6，马迎民7，李俊生8   

  1. 1首都医科大学附属北京朝阳医院疝和腹壁外科，北京 100043；2中国医科大学附属第四医院普外科，辽宁沈阳110000；3山东大学齐鲁医院普外科，山东济南250012；4上海交通大学附属瑞金医院普外科，上海200020；5复旦大学附属华东医院普外科，上海200040；6复旦大学生殖与发育研究院上海市计划生育科学研究所  计划生育药具重点实验室，上海200020；7首都医科大学附属北京朝阳医院呼吸病研究所，北京100043；8中南大学附属中大医院普外科，江苏南京210009
  • 出版日期:2019-08-01 发布日期:2019-08-01

  • Online:2019-08-01 Published:2019-08-01

摘要：

目的    调查分析我国成年人腹股沟疝治疗现状和围手术期静脉血栓栓塞症（VTE）相关事件。方法    对2017-01-01—2017-12-31中国大陆58家大型医院中因腹股沟疝住院的所有病人进行回顾性调查，以Caprini评分对全部病人进行分层分析和数据统计，对相关数据进行分析。结果    58家医院共收治腹股沟疝住院病人14322例，经数据校对和数据清洗后，13886例（97.0%）对象符合纳入排除标准。腹腔镜手术占51.2%，开放手术占48.8%。共观察到16例VTE事件，占全部病人0.1%（95%CI 0.11~0.13）。其中Caprini评分高危组和中危组VTE发生率分别为0.2%（95%CI 0.18~0.20）和0.02%（95%CI 0.01~0.03），前者明显高于后者（P=0.000），低危组没有发现VTE事件。全部病人中，仅3250例（23.4%）在诊治过程中进行了Caprini风险评估，仅13.2%的对象接受了VTE预防措施（无论适当与否），其中接受适当预防的比例仅为1.2%。结论    我国成人腹股沟疝围手术期VTE的评估和预防被严重忽视、术后VTE发病情况被低估，高龄、疝修补手术、全身麻醉、VTE病史及家族史等危险因素目前尚未引起医生足够的重视。

关键词: 腹股沟疝, 预防, 静脉血栓栓塞症

Abstract:

Investigation of prevalence for perioperative venous thromboembolism and risk factors of the present situation in Chinese adults patient with inguinal hernia(CHAT-1)        WANG Ming-gang*, LI Hang-yu, ZHANG Guang-yong, et al. *Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University,Beijing100043,China
Corresponding author：CHEN Jie, E-mail：chenjiejoe@sina.com
Abstract    Objective    To investigate and analyze the current situation of inguinal hernia treatment and postoperative venous thromboembolism（VTE）events in Chinese adults. Methods    From January 1, 2017 to December 31, 2017, the patients who were hospitalized with inguinal hernia in 58 large hospitals in mainland China were retrospectively analyzed by means of questionnaire. After data cleaning, all patients were stratified and statistically analyzed using Caprini score. Results    A total of 14 322 questionnaires were received from 58 different hospitals. After data patching and data cleaning, a total of 13 886 questionnaires (97.0%) were retained in accordance with the standard. The ratio of laparoscopic surgery and open surgery was 51.2% and 48.8% respectively. A total of 16 VTE events were observed, accounting for 0.1% (95% CI 0.11-0.13). The incidence of VTE was 0.2% (95%CI 0.18-0.20) in the high-risk group and 0.02% (95%CI 0.01-0.03) in the middle-risk group. The incidence of VTE in the high-risk group was significantly higher than that in the middle-risk group (P=0.000). No VTE event was found in the low-risk group. Of all patients, only 3250 (23.4%) underwent Caprini risk assessment, with 13.2% receiving any prevention, whether appropriate or not, and only 1.2% receiving appropriate prevention. Conclusion    The incidence of VTE event after operation of inguinal hernia in Chinese adults is severely underestimated, and has not been paid enough attention by surgeons at present.

Key words: inguinal hernia, prophylaxis, venous thromboembolism