>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
Caprini血栓风险评估模型预测妇科恶性肿瘤手术患者DVT风险的有效性研究
作者:娄英华1  沈怡2 
单位:1. 湖北三峡职业技术学院 附属医院, 湖北 宜昌 443001;
2. 华中科技大学同济医学院 附属协和医院, 湖北 武汉 430022
关键词:Caprini风险评估模型 妇科手术 深静脉血栓形成 风险评估 
分类号:R737.3
出版年·卷·期(页码):2017·36·第三期(333-337)
摘要:

目的:分析Caprini血栓风险评估模型在妇科恶性肿瘤手术患者下肢深静脉血栓形成(DVT)筛选中的有效性。方法:选择妇科恶性肿瘤手术住院患者中确诊为DVT的患者53例作为DVT组,同期入院的106例无DVT的妇科恶性肿瘤手术住院患者作为对照组。采用Caprini血栓风险评估模型对两组患者进行回顾性风险评分、DVT危险度分级。结果:DVT组患者Caprini评分明显高于对照组(7.8±2.6 vs 4.1±2.2,P<0.001)。DVT组患者中极高危所占比例最高(56.6%),其次为高危(22.6%);对照组高危所占比例最高(30.2%),其次为低危(29.2%),两组构成差异有统计学意义(P<0.001)。肥胖、肺炎(术后1个月内发生)、下肢水肿(1个月内)、大手术(1个月内)、恶性肿瘤(既往或现患)、DVT/PE疾病史、DVT/PE家族史等7个Caprini风险评估模型中的危险因素是妇科恶性肿瘤患者术后发生DVT的主要危险因素。极高危和高危患者是DVT发病的高危人群(发病风险分别为低危患者的12.743倍和2.132倍)。结论:Caprini血栓风险评估模型可以较好地预测妇科恶性肿瘤手术患者术后DVT的发病风险。

Objective:To analyze the validity of Caprini risk assessment scale in the evaluation of lower extremity deep vein thrombolysis(DVT)risk in gynecologic cancer patients after surgery. Methods:Fifty-three cases of DVT patients admitted were collected as DVT group, and 106 patients without DVT admitted during the same period were selected as control group. Risks in patients of both groups were retrospectively assessed with the Caprini risk assessment model. Results:Caprini score(7.8±2.6)of DVT group was higher than that of the control group(4.1±2.2)(P<0.001); the proportion of highest risk was 56.6% followed by higher risk(22.6%). In the control group, the proportion of the highest risk was 30.2% followed by low risk(29.2%), showing statistically significant difference between the two groups(P<0.001). The results indicated that obesity, pneumonia(<1 month), edema of lower extremity(<1 month), surgery(<1 month)and malignant tumor(past or present), DVT/PE disease history and DVT/PE family history were the major risk factors of the occurrence of DVT in patients with gynecological malignant tumor after operation. The highest and higher risk patients of gynecological malignant tumors evaluated with the Caprini risk assessment model were at higher risk for DVT. Compared with the low-risk patients, the incidence of DVT in the highest and higher risk of gynecologic malignant tumor patients scored by Caprini was respectively 12.743 and 2.132 times higher. Conclusion:Caprini risk assessment model can effectively assess the risk of DVT in gynecologic cancer patients after surgery.

参考文献:

[1] 黄静,阳志军,张洁清,等.妇科恶性肿瘤并发深静脉血栓形成的危险因素及预后影响因素分析[J].中华妇产科杂志,2015,50(10):762-769.
[2] 高洁,肖欢,周勤,等.妇科恶性肿瘤患者盆腔手术后下肢深静脉血栓形成的预防[J].中华全科医师杂志,2015,14(12):967-968.
[3] 黄静,李力.妇科恶性肿瘤相关的静脉血栓栓塞的研究进展[J].中华妇产科杂志,2015,50(2):151-153.
[4] ELYAMANY G,ALZAHRANI A M,BUKHARY E.Cancer-associated thrombosis:an overview[J].Clin Med Insights Oncol,2014,8:129-137.
[5] BAHL V,HU H M,HENKE P K,et al.A validation study of a retrospective venous thromboembolism risk scoring method[J].Ann Surg,2010,251(2):344-350.
[6] PANNUCCI C J,BARTA R J,PORTSCHY P R,et al.Assessment of postoperative venous thromboembolism risk in plastic surgery patients using the 2005 and 2010 Caprini Risk score[J].Plast Reconstr Surg,2012,130(2):343-353.
[7] PANNUCCI C J,BAILEY S H,DRESZER G,et al.Validation of the Caprini risk assessment model in plastic and reconstructive surgery patients[J].J Am Coll Surg,2011,212(1):150-112.
[8] 徐留海,曾勇,黄卫,等.基于Caprini血栓风险模型评估膝关节镜手术患者深静脉血栓形成的风险性[J].中国组织工程研究,2016,20(17):24434-24440.
[9] 周海霞,唐永江,王岚,等.Caprini风险评估模型筛选内科住院患者静脉血栓栓塞症的有效性[J].中华医学杂志,2013,93(24):1864-1867.
[10] 张晓勤,何丹,黎嘉嘉,等.Caprini血栓风险评估量表评估重症住院患者静脉血栓栓塞风险的有效性研究[J].四川大学学报:医学版,2015,46(5):732-735.
[11] WALKER A J,CARD T R,WEST J,et al.Incidence of venous thromboembolism in patients with cancer -a cohort study using linked United Kingdom databases[J].Eur J Cancer,2013,49(6):1404-1413.
[12] SEMB V B,TVEIT A.Limited malignancy screening of patients with idiopathic venous thromboembolism[J].Tidsskr Nor Laegeforen,2014,134(4):407-411.
[13] 张震宇.妇科恶性肿瘤术后下肢深静脉血栓形成的特点与预防[J].实用妇产科杂志,2014,30(9):650-651.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 405529 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364