关键词: 外科, 术后, 静脉血栓栓塞症, 下肢静脉血栓, 肺动脉栓塞, 影响因素

Abstract: Objective To analyze the occurrence of postoperative venous thromboembolism and explore its influencing factors, so as to provide reference for related prevention and treatment. Methods Taking patients after surgery in a hospital in Panzhihua from January 2019 to December 2020 as the research object, collecting the basic information and surgery-related data, and performing preoperative physiological and biochemical index tests. Venous thrombosis was detected once within 24, 48 and 72 hours after operation. Descriptive epidemiological analysis method was used to analyze the results, and univariate and multivariate analysis methods were used to analyze the influencing factors of postoperative venous thromboembolism. Results A total of 1 370 postoperative patients were studied. The incidence of venous thromboembolism was 7.4%。Among them, there were 85 cases of lower extremity venous thromboembolism （83.3%） and 17 cases of pulmonary embolism （16.7%）。Venous thromboembolism of lower extremity was common in the left lower extremity（69.4%）, with common symptoms of swelling, pain and varicose vein. The common symptoms of pulmonary embolism were dyspnea, shortness of breath and chest pain. The results of multivariate analysis showed that the older the age （OR=1.239）, the patients with underlying diseases （OR=1.351）, the open surgery （OR=2.268）, the operation time ≥60 min （OR=1.496）, the postoperative D-dimer level ≥500 μg/L （OR=2.869）, and postoperative bedridden time ≥24 h （OR=3.136） were risk factors for venous thromboembolism in patients after surgery. The use of preventive anticoagulants （OR=0.710） was a protective factor for venous thromboembolism in patients after surgery. Conclusion The postoperative venous thromboembolism is mainly lower extremity venous thromboembolism, which is affected by many factors, such as age, operation method, operation time, postoperative D-dimer level, postoperative bedridden time, application of preventive anticoagulants and so on. Clinical attention should be paid to strengthen the intervention measures for high-risk patients to reduce the incidence of postoperative venous thromboembolism.

Key words: Surgery, Postoperative, Venous thromboembolism, Lower extremity venous thrombosis, Pulmonary embolism, Influencing factor