两种血栓风险评估模型在住院患者深静脉血栓形成中的预测价值研究  

The Predictive Value of Two Risk Assessment Models for Deep Venous Thrombosis in Hospitalized Patients

作　　者：周亚婷[1] 史颜梅 白琳[1] 吕梦[1] 张淑香[2] Zhou Yating;Shi Yanmei;Bai Lin;Lv Meng;Zhang Shuxiang(School of Nursing, Shandon4g University,Jinan 250012, Shandong Province,China;Department of Nursing,Qianfoshan Hospital,Jinan 250014,Shandong Province,China)

机构地区：[1]山东大学护理学院,山东济南250012 [2]山东省千佛山医院护理部,山东济南250012

出　　处：《解放军护理杂志》2018年第4期27-31,47,共6页Nursing Journal of Chinese People's Liberation Army

基　　金：山东省软科学研究计划(2017RKB14047)

摘　　要：目的比较Caprini血栓风险评估模型及Autar血栓风险评估量表对住院患者深静脉血栓(deep vein thrombosis,DVT)形成的预测价值。方法采用回顾性病例对照研究的方法,便利抽样法选取院内2013年1月至2016年12月住院患者中确诊为DVT的269例患者为病例组,随机269例非DVT患者为对照组。收集两组患者的临床资料,分别采用Caprini风险评估模型及Autar血栓风险评估量表对其血栓发生风险进行评估,探讨风险分层及相关危险因素与DVT发生风险之间的关系。结果两种风险评估模型对病例组患者的DVT风险评估平均得分均高于对照组(P<0.01),但针对高危患者的筛选,Caprini风险评估模型诊出的高风险率显著高于Autar血栓风险评估量表(P<0.01);比较ROC曲线下面积发现,Caprini风险评估模型曲线下面积大于Autar血栓风险评估量表(P<0.01);此外,Caprini风险评估模型风险分层结果显示,随着风险分层的增高,患者DVT的发生风险也在逐级递增,两者呈正相关关系(P<0.05);进一步对Caprini风险评估模型中的危险因素进行Logistic回归分析探讨危险因素与DVT发生风险的相关性,共计8个危险因素是DVT发生的高危因素(P<0.05)。结论 Caprini风险评估模型对住院患者DVT发生风险的预测较Autar血栓风险评估量表更有效,根据DVT风险分层结果对患者实施针对性护理预防,为院内血栓防治提供了有力保障,可在临床推广使用。Objective To compare the predictive value of the Caprini and Autar risk assessment model for deep venous thrombosis（DVT）in hospitalized patients.Methods We used a retrospective case-control study to collect data.A total of269 patients had having DVT during hospitalization from January 2013 to December 2016 were recruited.Another 269 nonDVT patients were randomly selected from the patients who were admitted into the same departments as controls.Both groups were assessed with the Caprini and Autar risk assessment model.The assessment results were compared,and the risk stratification and the relationship between influencing factors and DVT risks were discussed.Results The average risk scores of DVT patients in Bboth risk assessment models average risk score in the DVT patients were significantly higher than that those observed in the non-DVT patients（P〈0.01）.More DVT patients were classified into the high risk level by the Caprini risk assessment model than those in the Autar risk assessment scale（P〈0.01）.Meanwhile,the area under curve（AUC）of the receiver operating characteristic（ROC）in the Caprini risk assessment model was higher than that in the Autar risk assessment scale（P〈0.01）.Inaddition,as the risk stratification increases,the risk of DVT increases linearly with it（P〈0.05）.Eight high risk factors of DVT were found in Tthe logistic regression for was performed to analysisanalyzing the relationship between the risk factors and the DVT risk,eight risk factors in the Caprini risk assessment model（P〈0.05）.Conclusion The Caprini risk assessment model was suggested to be more effective than the Autar risk assessment scale for identification of hospitalized patients at risk for DVT.According to the results of DVT risk stratification,Implementation of targeted nursing intervention was implementedbased on the results of DVT risk stratification,which could provided a powerful guarantee for the prevention and treatment of the DVT,whichit is worth for clinical promotion.

关 键 词：静脉血栓形成 危险因素 风险评估 住院患者 护理 

分 类 号：R473.54[医药卫生—护理学] R543.6[医药卫生—临床医学]