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首页> 外文期刊>Journal of the American College of Surgeons >Use of helical CT is associated with an increased incidence of postoperative pulmonary emboli in cancer patients with no change in the number of fatal pulmonary emboli.
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Use of helical CT is associated with an increased incidence of postoperative pulmonary emboli in cancer patients with no change in the number of fatal pulmonary emboli.

机译：螺旋CT的使用与癌症患者术后肺栓塞的发生率增加相关，而致命肺栓塞的数量没有变化。

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BACKGROUND: Multidetector computed tomography (MDCT) scanning technology has increased the ease with which pulmonary emboli (PE) are evaluated. Our aim was to determine whether the incidence and severity of postoperative PE have changed since adoption of multidetector computed tomography. STUDY DESIGN: A prospective postoperative morbidity and mortality database from a single institution was used to identify all cancer patients who experienced a PE within 30 days of thoracic, abdominal, or pelvic operations. The incidence, type (central, segmental, and subsegmental), and severity of PE were examined. RESULTS: A total of 295 PE were documented among 47,601 postoperative cancer patients. The incidence of PE increased yearly from 2.3 per 1,000 patients in 2000 to 9.3 per 1,000 patients in 2005 (p < 0.0001). This corresponded to an increasing number of CT scans of the chest performed (6.6 CT scans per 1,000 postoperative patients in 2000 versus 45 in 2005; p < 0.0001). The increased incidence was because of a 7.8% (CI, 4.0 to 11.7) and 5.4% (CI, 4.1 to 6.7) average annual increase in segmental and subsegmental PE, respectively. There was no change in the number of central (0.1%; CI, -1.0 to 1.12) PE. Overall incidence of fatal PE was 0.4 and did not change during the time period (p = 0.3). A central PE was more commonly associated with hypoxia, ICU admission, and 30-day mortality (33% versus 5% for peripheral; p = 0.02). CONCLUSIONS: Chest CT scans are being performed more frequently on postoperative cancer patients and have resulted in an increased diagnosis of peripheral PE. The clinical significance of, and optimal treatment for, diagnosed subsegmental PE are incompletely defined.
机译：背景：多探测器计算机断层扫描（MDCT）扫描技术提高了评估肺栓塞（PE）的简便性。我们的目的是确定自采用多探测器计算机断层扫描以来，术后PE的发生率和严重性是否已改变。研究设计：使用来自单个机构的前瞻性术后发病率和死亡率数据库来识别所有在胸部，腹部或骨盆手术后30天内经历过PE的癌症患者。检查了PE的发生率，类型（中心，节段和亚节段）和严重程度。结果：47601例术后癌症患者中共记录了295例PE。 PE的发病率逐年增加，从2000年的每千名患者2.3例增加到2005年的每千例9.3例（p <0.0001）。这与增加的胸部CT扫描数量相对应（2000年每1000名术后患者6.6 CT扫描，而2005年为45例; p <0.0001）。发病率上升的原因是，分段和分段PE的年平均增长率分别为7.8％（CI为4.0至11.7）和5.4％（CI为4.1至6.7）。中央PE的数量没有变化（0.1％; CI，-1.0至1.12）。致命性PE的总发生率为0.4，在这段时间内没有变化（p = 0.3）。中央PE更常见于缺氧，ICU入院和30天死亡率（33％对5％的外周血; p = 0.02）。结论：对术后癌症患者进行胸部CT扫描的频率更高，并增加了对周围PE的诊断。被诊断的亚节段性PE的临床意义和最佳治疗方法尚未完全确定。

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