Caprini血栓评估量表对急诊重症监护室患者静脉血栓栓塞症预防价值  

Prevention value of Caprini scale against VTE for patients in EICU

作　　者：潘龙飞[1] 丁新爱[1] 张瑞[1] 彭卓[1] 米勇锋 党晓燕[1] PAN Long-fei,DING Xin-ai,ZHANG Rui,PENG Zhuo,MI Yong-feng,DANG Xiao-yan(Department of Emergency,The Second Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710004,Chin)

机构地区：[1]西安交通大学第二附属医院急诊科,陕西西安710004 [2]武警陕西省总队医院急诊科,陕西西安710054

出　　处：《临床军医杂志》2018年第9期1036-1038,1042,共4页Clinical Journal of Medical Officers

基　　金：陕西省科技攻关项目(2014K11030206)

摘　　要：目的探讨Caprini血栓评估量表对急诊重症监护室(EICU)患者静脉血栓栓塞症(VTE)的预防价值。方法选取自2013年12月至2016年1月西安交通大学第二附属医院EICU收治的100例患者,随机分为常规组(n=50)与观察组(n=50),观察组根据Caprini血栓评估量表的评分分为低危组、中危组、高危组与极高危组。常规组给予常规治疗;观察组进行Caprini血栓评估量表评分,根据评分给予物理预防或低分子肝素预防。比较常规组与观察组住院时间、EICU入住时间、深静脉血栓(DVT)及肺栓塞(PE)发生情况,并于入院时对观察组患者进行急性生理和慢性健康评估Ⅱ(APACHEⅡ)评分、序贯性器官衰竭评估(SOFA)评分,并分别在低危组、中危组、高危组和极高危组内进行比较;分析与Caprini血栓评估量表相关的因素。结果常规组患者住院时间为(16. 23±3. 04) d,EICU入住时间为(8. 30±1. 26) d;观察组患者住院时间为(10. 04±2. 25)d,EICU入住时间为(5. 48±1. 49)d,观察组均短于常规组,差异有统计学意义(P <0. 05)。常规组患者1周DVT发生率为12%(6/50),2周DVT发生率为16%(8/50);观察组患者1周DVT发生率为0,2周DVT发生率为2%(1/50),观察组均低于常规组,差异有统计学意义(P <0. 05)。观察组患者PE发生率为0,低于常规组的8%(4/50),但组间比较,差异无统计学意义(P> 0. 05)。与低危组比较,高危组、极高危组患者入院时APACHEⅡ评分较高,中危组、高危组与极高危组入院时SOFA评分较高,差异均有统计学意义(P <0. 05)。Pearson相关性分析结果显示,Caprini血栓评估量表评分与性别无相关性(P> 0. 05),但与年龄、SOFA评分及APACHEⅡ评分呈正相关性(P <0. 05)。结论 Caprini血栓评估量表评估对EICU患者VTE发生的预测具有积极意义,根据评估进行预防治疗可缩短住院时间及EICU入住时间,且SOFA评分及APACHEⅡ评分高的危重患者建议采用Caprini血栓评估量表进行评估。Objective To investigate the value of Caprini scale used for prevention against venous thrombus embolism（VTE）for patients in EICU.Methods A retrospective study was performed on 100 cases of patients who were admitted in EICU from December 2013 to January 2016.Patients were randomly divided into the conventional group（ n =50）and the observation group（ n =50）;according to the Caprini scale,patients in the observation group were subdivided into the low-risk group,middle-risk group,high-risk group and extremely high-risk group.Routine treatment was given to the conventional group;in the observation group,Caprini scale was scored,and physical prevention or low molecular heparin prevention was given according to the score.The length of hospital stay,EICU check-in time,deep vein thrombosis（DVT）and pulmonary embolism（PE）were compared between the conventional group and the observation group.On admission of patients in the observation group were compared with acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ）score,sequential organ failure assessment（SOFA）score in the four groups,factors related to the Caprini scale were analyzed.Results The hospitalization time of patients in the conventional group was （16.23±3.04）days,and time of EICU was （8.30±1.26）days.The hospitalization time of the patients in the observation group was （10.04±2.25）days,and time of the EICU was （5.48±1.49）days.The time in the observation group was shorter than that in the conventional group,and the difference was statistically significant（ P 〈0.05）.The incidence of DVT was 12%（6/50）in 1 week and 16%（8/50）in 2 weeks in the conventional group.In the observation group,the incidence of DVT in 1 week was 0,in 2 weeks was 2%（1/50）,and the incidence of the observation group was lower than that in the conventional group（ P 〈0.05）.PE incidence was 0 in the observation group,which was lower than 8%（4/50）in the conventional group,while the difference was not statistically s

关 键 词：急诊重症监护室 静脉血栓栓塞 深静脉血栓 肺栓塞 Caprini血栓评估量表 

分 类 号：R459.7[医药卫生—急诊医学]