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

发布时间：2019-01-09 19:17

【摘要】：背景:膝关节镜手术后容易发生下肢深静脉血栓。而当前深静脉血栓缺乏特异性的临床表现,临床上急需一种快速、方便、可靠的风险评估工具来评估高危人群,以便预防和干预。国外Caprini血栓风险评估量表评估血栓发生风险的有效性已被大量研究所证实,当前国内研究较少。目的:验证Caprini血栓风险评估模型预测膝关节镜手术患者下肢深静脉血栓形成风险的有效性,探讨膝关节镜手术患者预防深静脉血栓形成的有效策略。方法:采用随机对照研究设计,连续性收集2008年1月至2015年6月三峡大学仁和医院骨科膝关节镜手术患者中确诊的49例深静脉血栓形成患者作为病例组,随机选择同时期入院的98例未发生深静脉血栓形成的膝关节镜手术患者作为对照组。按照Caprini风险评估量对两组患者进行深静脉血栓形成风险评估、危险度分级,探讨危险度分级与深静脉血栓形成发病风险的相关关系。结果与结论:1基本情况比较:深静脉血栓形成组患者的术侧肢体止血带应用时间、吸烟者所占比例、深静脉血栓形成和(或)肺血栓栓塞症疾病史患者所占比例则高于对照组(P0.05);2深静脉血栓形成组患者Caprini评分明显高于对照组(P0.001);深静脉血栓形成组患者中极高危患者所占比例最高(53%),其次为高危(25%),高危及以上合计占78%,对照组中高危所占比例最多(32%),其次为低危(29%),两组患者危险度分级的构成之间差异有显著性意义(P0.001);3深静脉血栓形成组及对照组中,均有患者深静脉血栓形成和(或)肺血栓栓塞症疾病史与Caprini评分呈的正相关关系(P0.05);而深静脉血栓形成患者中Caprini评分还与术侧肢体止血带应用时间呈正相关关系(P0.05)。4Caprini危险度分级与深静脉血栓形成发病风险的Logistic回归分析显示:随着Caprini危险度分级的升高患者深静脉血栓形成的发病风险也明显增高,高危和极高危重症患者深静脉血栓形成的发病风险分别是低危患者的2.130和11.786倍;5提示基于Caprini血栓风险评估模型可以较好的预测膝关节镜手术患者术后深静脉血栓形成的发病风险。
[Abstract]:Background: deep venous thrombosis of lower extremity is easy to occur after knee arthroscopy. However, there is no specific clinical manifestation of DVT at present. A rapid, convenient and reliable risk assessment tool is urgently needed to evaluate high risk groups in order to prevent and intervene. The effectiveness of Caprini Thrombosis risk Assessment scale in foreign countries has been confirmed by a large number of studies. Objective: to evaluate the effectiveness of Caprini thrombotic risk assessment model in predicting the risk of deep venous thrombosis (DVT) in patients undergoing knee arthroscopy, and to explore the effective strategies for preventing DVT in patients undergoing knee arthroscopy. Methods: from January 2008 to June 2015, 49 patients with deep venous thrombosis (DVT) who were diagnosed by arthroscopy in Department of Orthopaedics, Renhe Hospital, three Gorges University, were selected as the case group. 98 cases of knee arthroscopy without deep venous thrombosis were randomly selected as control group. According to the Caprini risk assessment, the risk of deep venous thrombosis (DVT) was evaluated in two groups, and the correlation between the risk classification and the risk of DVT was discussed. Results and conclusion: 1 comparison of the basic conditions: the operative limb tourniquet duration and the proportion of smokers in the patients with deep venous thrombosis were compared. The proportion of patients with deep venous thrombosis and / or pulmonary thromboembolism history was higher than that of control group (P0.05). 2the Caprini score in the deep venous thrombosis group was significantly higher than that in the control group (P0. 001). In the group of deep venous thrombosis, the proportion of extremely high risk patients was the highest (53%), followed by high risk group (25%), high risk group and above group accounted for 78%. In the control group, the proportion of high risk group was the highest (32%), the second was low risk group (29%). There was significant difference in the composition of risk grade between the two groups (P0.001). 3There was a positive correlation between the disease history of deep vein thrombosis and / or pulmonary thromboembolism and Caprini score in both the deep vein thrombosis group and the control group (P0.05). However, the Caprini score in patients with deep venous thrombosis was positively correlated with the length of use of the tourniquet (P0.05). The Logistic regression analysis between the 4Caprini risk classification and the risk of deep venous thrombosis showed that: with Caprini risk: The risk of deep venous thrombosis was also significantly increased in patients with elevated risk grades. The risk of deep venous thrombosis was 2.130 and 11.786 times higher in high risk and very high risk patients than in low risk patients, respectively. The results suggest that the risk assessment model based on Caprini can predict the risk of deep venous thrombosis after knee arthroscopy.
【作者单位】：三峡大学仁和医院骨科;
【基金】：湖北省卫生计生委科研项目(WJ2015084)~~
【分类号】：R687.4

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