Effectiveness and risk factor analysis of venous thromboembolism prevention in the management of day surgery wards_West China Medical Journal

Authors：

ZHANG Yan ¹ , HUANG Guofei ² ,  LIU Hang ¹

1. Daytime Diagnosis and Treatment Center, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
2. Department of Vascular Surgery, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

LIU Hang, Email: liuhanghoney@163.com

Keywords：

Day surgery; venous thromboembolism prevention and control; ward management; risk factor

DOI：

10.7507/1002-0179.202411310

Video：

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Objective To observe the effectiveness of prevention and management of venous thromboembolism (VTE) in the day surgery wards, analyze the influencing factors of VTE occurrence in postoperative patients, in order to reduce the occurrence of VTE adverse events, improve the utilization of medical resources, and enhance the quality of day care. Methods The patient data of the Daytime Diagnosis and Treatment Center of Deyang People’s Hospital between January 2020 and December 2023 were retrospectively selected. According to the implementation time of VTE prevention and control in the day surgery wards, patients between 2022 and 2023 were selected as the observation group, and patients between 2020 and 2021 were selected as the control group. The incidence and the influencing factors of postoperative of VTE were compared between the two groups. Results A total of 2 300 patients were included, with 1 150 cases in each group. The comparison of in-hospital [12 cases (1.0%) vs. 3 cases (0.3%)] and post discharge [7 cases (0.6%) vs. 1 case (0.1%)] VTE incidence rates between the control group and the observation group showed statistically significant differences (P＜0.05). Among the 9 specialties in the Daytime Diagnosis and Treatment Center, the incidence of VTE in thoracic surgery (1.58%), vascular surgery (1.51%), and hepatobiliary surgery (1.29%) ranked among the top 3. The results of multiple logistic regression analysis showed that fourth grade surgery, lower limb surgery, and large intraoperative bleeding (>100 mL) were the influencing factors for postoperative VTE (P<0.05). Conclusions There are many reasons for VTE occurrence, and it is necessary to prevent and treat VTE in the day surgery ward. More attention should be paid to the patient’s surgical grading, intraoperative bleeding volume, and surgical site.

Citation： ZHANG Yan, HUANG Guofei, LIU Hang. Effectiveness and risk factor analysis of venous thromboembolism prevention in the management of day surgery wards. West China Medical Journal, 2025, 40(2): 223-228. doi: 10.7507/1002-0179.202411310 Copy

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2.	嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
3.	徐蕾, 刘小南, 俞德梁, 等. 基于日间模式的手术患者当日出院的影响因素分析. 华西医学, 2022, 37(2): 194-198.
4.	方路, 黄明君, 戴燕, 等. 四川大学华西医院日间手术围手术期镇痛管理规范. 华西医学, 2023, 38(2): 284-287.
5.	秦小莉, 藕顺龙, 高秀容, 等. 静脉血栓栓塞症风险评估工具的系统评价. 中国循证医学杂志, 2024, 24(6): 700-707.
6.	刘迎军, 潘昭锦, 李大军, 等. 行择期手术非小细胞肺癌患者出院后静脉血栓栓塞症发生风险的影响因素研究. 临床肿瘤学杂志, 2024, 29(8): 770-773.
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9.	上海市肺栓塞与深静脉血栓防治联盟. 下肢孤立性远端深静脉血栓超声检查实践: 上海专家建议. 中华超声影像学杂志, 2021, 30(12): 1013-1017.
10.	刘坚军, 董智慧, 符伟国. 普通外科围手术期静脉血栓栓塞症防治中血管外科干预原则与策略. 中国实用外科杂志, 2020, 40(5): 515-519.
11.	上海市普通外科临床质量控制中心. 上海市普通外科住院病人静脉血栓栓塞症防治管理规范. 中国实用外科杂志, 2018, 38(3): 245-249.
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13.	李燕如, 林茜, 胡晓燕. 结直肠癌患者术后并发静脉血栓栓塞的相关影响因素及预防措施分析. 医学理论与实践, 2023, 36(8): 1327-1329.
14.	姚灵琦, 常啸岩, 沈志平, 等. 全孔机器人与胸腔镜在ⅠA 期非小细胞肺癌肺叶切除术中疗效比较的回顾性队列研究. 中国胸心血管外科临床杂志, 2023, 30(10): 1390-1395.
15.	曲哲, 吴志宏, 郭开今. 下肢大关节手术围手术期抗凝治疗. 协和医学杂志, 2019, 10(6): 633-638.
16.	侯飞飞, 吕富荣, 王晓慧, 等. 腹腔镜与开腹手术术后静脉血栓栓塞症的临床分析. 重庆医科大学学报, 2016, 41(1): 102-105.
17.	Alshahwani AA, Dungey M, Lillie C, et al. Predictive value of the risk assessment and prediction tool (RAPT) score for primary hip and knee arthroplasty patients: a single-center study. Cureus, 2021, 13(3): e14112.
18.	Lieberman JR. Deep vein thrombosis prophylaxis: state of the art. J Arthroplasty, 2018, 33(10): 3107-3108.
19.	Shaikhouni A, Baum J, Lonser RR. Deep vein thrombosis prophylaxis in the neurosurgical patient. Neurosurg Clin N Am, 2018, 29(4): 567-574.
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21.	中国胸外科静脉血栓栓塞症研究组. 中国胸部恶性肿瘤围手术期静脉血栓栓塞症预防与管理指南(2022 版). 中华外科杂志, 2022, 60(8): 721-731.
22.	王晓伟, 万雷, 刘晓燕, 等. 脊柱外科手术后静脉血栓栓塞的研究进展. 中华骨与关节外科杂志, 2024, 17(5): 474-479.
23.	郑毅隽, 罗哲. 从重症监护角度思考普通外科围手术期静脉血栓栓塞症防治. 中国实用外科杂志, 2020, 40(5): 527-531.
24.	薛培君, 李宜瑶, 张婷, 等. 老年胸腔镜术后发生静脉血栓栓塞症患者临床特征及预后分析. 中华老年多器官疾病杂志, 2023, 22(2): 103-109.
25.	四川天府新区医学会日间护理专业委员会. 日间手术病房“平急结合”管理模式专家共识. 华西医学, 2024, 39(2): 173-177.
26.	毕伟, 袁涛, 张兰英. 血管外科在 VTE 防治中的作用. 血管与腔内血管外科杂志, 2021, 7(10): 1145-1147, 1144.

1. Hall MJ, Schwartzman A, Zhang J, et al. Ambulatory surgery data from hospitals and ambulatory surgery centers: United States, 2010. Natl Health Stat Report, 2017(102): 1-15.
2. 嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
3. 徐蕾, 刘小南, 俞德梁, 等. 基于日间模式的手术患者当日出院的影响因素分析. 华西医学, 2022, 37(2): 194-198.
4. 方路, 黄明君, 戴燕, 等. 四川大学华西医院日间手术围手术期镇痛管理规范. 华西医学, 2023, 38(2): 284-287.
5. 秦小莉, 藕顺龙, 高秀容, 等. 静脉血栓栓塞症风险评估工具的系统评价. 中国循证医学杂志, 2024, 24(6): 700-707.
6. 刘迎军, 潘昭锦, 李大军, 等. 行择期手术非小细胞肺癌患者出院后静脉血栓栓塞症发生风险的影响因素研究. 临床肿瘤学杂志, 2024, 29(8): 770-773.
7. 许琦, 杨春建, 陈春丽. 住院患者下肢深静脉血栓形成预防的现状及其相关因素分析. 血管与腔内血管外科杂志, 2024, 10(6): 729-733.
8. Li H, Zhang W, Lu Q, et al. Which frequency of ankle pump exercise should be chosen for the prophylaxis of deep vein thrombosis?. Inquiry, 2022, 59: 469580221105989.
9. 上海市肺栓塞与深静脉血栓防治联盟. 下肢孤立性远端深静脉血栓超声检查实践: 上海专家建议. 中华超声影像学杂志, 2021, 30(12): 1013-1017.
10. 刘坚军, 董智慧, 符伟国. 普通外科围手术期静脉血栓栓塞症防治中血管外科干预原则与策略. 中国实用外科杂志, 2020, 40(5): 515-519.
11. 上海市普通外科临床质量控制中心. 上海市普通外科住院病人静脉血栓栓塞症防治管理规范. 中国实用外科杂志, 2018, 38(3): 245-249.
12. 王乔宇, 武明芬, 柳鑫, 等. 2021 中国静脉血栓栓塞症防治抗凝药物的选用与药学监护指南. 中国临床药理学杂志, 2021, 37(21): 2999-3016.
13. 李燕如, 林茜, 胡晓燕. 结直肠癌患者术后并发静脉血栓栓塞的相关影响因素及预防措施分析. 医学理论与实践, 2023, 36(8): 1327-1329.
14. 姚灵琦, 常啸岩, 沈志平, 等. 全孔机器人与胸腔镜在ⅠA 期非小细胞肺癌肺叶切除术中疗效比较的回顾性队列研究. 中国胸心血管外科临床杂志, 2023, 30(10): 1390-1395.
15. 曲哲, 吴志宏, 郭开今. 下肢大关节手术围手术期抗凝治疗. 协和医学杂志, 2019, 10(6): 633-638.
16. 侯飞飞, 吕富荣, 王晓慧, 等. 腹腔镜与开腹手术术后静脉血栓栓塞症的临床分析. 重庆医科大学学报, 2016, 41(1): 102-105.
17. Alshahwani AA, Dungey M, Lillie C, et al. Predictive value of the risk assessment and prediction tool (RAPT) score for primary hip and knee arthroplasty patients: a single-center study. Cureus, 2021, 13(3): e14112.
18. Lieberman JR. Deep vein thrombosis prophylaxis: state of the art. J Arthroplasty, 2018, 33(10): 3107-3108.
19. Shaikhouni A, Baum J, Lonser RR. Deep vein thrombosis prophylaxis in the neurosurgical patient. Neurosurg Clin N Am, 2018, 29(4): 567-574.
20. Morris RJ. Research quality in the study of mechanical methods of deep vein thrombosis prophylaxis. Phlebology, 2020, 35(5): 297-304.
21. 中国胸外科静脉血栓栓塞症研究组. 中国胸部恶性肿瘤围手术期静脉血栓栓塞症预防与管理指南(2022 版). 中华外科杂志, 2022, 60(8): 721-731.
22. 王晓伟, 万雷, 刘晓燕, 等. 脊柱外科手术后静脉血栓栓塞的研究进展. 中华骨与关节外科杂志, 2024, 17(5): 474-479.
23. 郑毅隽, 罗哲. 从重症监护角度思考普通外科围手术期静脉血栓栓塞症防治. 中国实用外科杂志, 2020, 40(5): 527-531.
24. 薛培君, 李宜瑶, 张婷, 等. 老年胸腔镜术后发生静脉血栓栓塞症患者临床特征及预后分析. 中华老年多器官疾病杂志, 2023, 22(2): 103-109.
25. 四川天府新区医学会日间护理专业委员会. 日间手术病房“平急结合”管理模式专家共识. 华西医学, 2024, 39(2): 173-177.
26. 毕伟, 袁涛, 张兰英. 血管外科在 VTE 防治中的作用. 血管与腔内血管外科杂志, 2021, 7(10): 1145-1147, 1144.

West China Medical Journal

Effectiveness and risk factor analysis of venous thromboembolism prevention in the management of day surgery wards

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