术后静脉血栓栓塞（VTE）是导致发病率和死亡率增加的重要原因。自体乳房重建手术中外科医生使用抗凝药物进行血栓预防的研究较少。本研究的目的是确定自体乳房重建术中乳腺癌患者VTE的发生率，并比较术后抗凝药物的成本效益。使用TriNetX LLC.国家健康研究网络数据库，检索2002年至2022年间接受自体乳房重建手术的乳腺癌患者。计算手术后30天内VTE发生率，并进行盈亏分析以确定抗凝药物的盈亏平衡点。 本研究共纳入8,221例患者。未使用抗凝药物组的VTE发生率（4.0%）明显高于使用抗凝药物组（2.6%）（*p=0.0008）。对于需要30天疗程的高风险患者和需要7天疗程的中等风险患者，肝素和依诺肝素的成本效益的盈亏分析结果分别为0.73%和1.63%以及0.20%和0.43%。 使用抗凝药物显著降低了自体乳房重建术后30天内VTE的风险。与依诺肝素相比，肝素在预防高风险和中等风险患者的VTE方面效果更为经济实惠。所提出的模型可以用于其他机构特定变量，供整形外科医生轻松应用以确定其选择的任何治疗方案的成本效益。 版权所有 © 2023 美国整形外科医师协会。

Post-operative venous thromboembolism (VTE) is a major source of morbidity and mortality. The use of thromboprophylaxis amongst surgeons is not well studied in autologous breast reconstruction. The purpose of this study was to determine the rate of VTE in breast cancer patients undergoing autologous breast reconstruction and to compare the cost-effectiveness of postoperative chemoprophylactic agents.The TriNetX LLC. National Health Research Network database was used to identify patients with breast cancer who underwent autologous breast reconstruction surgery between 2002-2022. The incidence of occurrence of VTE within the first 30 days of surgery was calculated. Then a break-even analysis was performed to determine the break-even rate of VTE at which the chemoprophylactic agent would be cost effective.A cohort of 8,221 patients was identified in this study. The rate of VTE was significantly higher in those without anticoagulation (4.0%) compared to those who received anticoagulation (2.6%) (*p=0.0008). The break-even analysis for heparin and enoxaparin's cost-effectiveness yielded ARRs of 0.73% and 1.63% for high risk patients requiring 30 days of therapy and 0.20% and 0.43% for moderate risk patients requiring 7 days of therapy, respectively.The use of thromboprophylaxis significantly lowered the risk of VTE within 30 days after autologous breast reconstruction. Heparin appeared to be more cost-effective at preventing VTE compared to enoxaparin for both high and moderate risk patients. The presented model holds potential for other institution-specific variables that can be easily applied by plastic surgeons to determine the cost-effectiveness of any therapy of their choice.Copyright © 2023 by the American Society of Plastic Surgeons.