2005版Caprini血栓风险评估模型在妇科盆腔手术患者中的应用价值  

The application value of Caprini thrombosis risk assessment model(2005) in Pelvic Surgery of Gynecology

作　　者：黄文蓉[1] 王海平[2] 张雪梅[1] 张奕平 解斐 彭燚琼[1] 刘全芳[2] HUANG Wenrong;WANG Haiping;ZHANG Xuemei;ZHANG Yiping;XIE Fei;PENG Yiqiong;LIU Quanfang(Gynaecology Department of the Second Hospital of Longyan,Fujian,Longyan 364000,China;Pharmacy Department of the Second Hospital of Longyan,Fujian,Longyan 364000,China)

机构地区：[1]福建省龙岩市第二医院妇科,福建龙岩364000 [2]福建省龙岩市第二医院药剂科,福建龙岩364000

出　　处：《中国医药科学》2019年第24期117-120,共4页China Medicine And Pharmacy

摘　　要：目的2005版Caprini血栓风险评估模型在妇科盆腔手术患者中的应用价值。方法选取2015年1月~2017年4月我院共行妇科盆腔手术3312例,将其中确诊术后发生VTE的62例患者作为实验组。采用随机数字表法以与实验组2∶1的比例随机选取同时期同科室并行相同手术但术后未发生血栓的住院患者临床资料,作为对照组。结果无VTE组患者Caprini评分显著较VTE组患者高,并且在对危险等级分级研究中,以Caprini评分模型进行VTE发生风险评分中,极高危患者占比为70.97%,显著高于占比为16.12%的对照组。通过对妇科盆腔手术患者进行对Caprini评分模型中诱发VTE的38个危险因素进行验证,结果显示,年龄、肥胖(BMI≥25kg/m^2)、静脉曲张、恶性肿瘤(既往或现患)、中心静脉置管、卧床时间>72h、手术时间、VTE疾病史、VTE家族史等是妇科盆腔手术患者术后发生VTE的主要危险因素,提示临床医生应关注以上危险因素及时给盆腔手术患者VTE预防措施。在对盆腔手术患者VTE发生风险与危险分级相关性研究中,经2005版Caprini评估评定为极高危者发生VTE风险是低中危组的24.116倍;高危者发生VTE风险是低中危组的2.674倍。结论在对妇科盆腔手术患者术后VTE发生风险上,2005版Caprini血栓风险评估模型具有良好的预测效果,可作为妇科盆腔手术患者VTE个体化预防有价值的评估工具,并且根据Caprini评分对患者进行发生风险评估层次不同开展对应性防治措施。Objective To discuss the application value of Caprini thrombosis risk assessment model(2005)in pelvic surgery of gynecology.Methods 3312 patients of gynecological pelvic surgery in our hospital from January 2015 to April 2017 were selected,among which 62 cases of VTE after diagnosis were taken as the experimental group,while 124 inpatients who underwent the same operation in the same department but did not have thrombus after operation were randomly selected as the control group.Results Caprini scores in the control group were significantly higher than those in the experimental group.In the study on risk rating,the Caprini scoring model was used to conduct the risk score for VTE occurrence,and the proportion of extremely high-risk patients was 70.97%,significantly higher than the control group of 16.12%.By analyzing the 38 risk factors for VTE in patients undergoing gynecological pelvic surgery in Caprini scoring model,the following main factors as age,obesity(BMI≥25kg/m^2),varicose veins,malignant tumors(previous or present),central venous catheterization,bed time>72h,operation time,history of VTE disease,and family history of VTE,etc.were found as the main risk factor for VTE after pelvic surgery,which suggested that clinicians should pay attention to the above risk factors and timely prevent VTE in pelvic surgery patients.In the study on the correlation between VTE risk and risk classification in pelvic surgery patients,the risk of VTE in the extremely highrisk group and high-risk group were 24.116 times and 2.674 times higher than those in the low and medium risk group by Caprini of 2005,respectively.Conclusion In terms of the risk of postoperative VTE in pelvic surgery patients of gynecology,Caprini thrombosis risk assessment model(2005)has a good prediction effect,which can be used as a valuable assessment tool for the individualized prevention of VTE in pelvic surgery patients of gynecology.In addition,according to Caprini scores,corresponding prevention and treatment measures can be carried out for pati

关 键 词：静脉血栓栓塞症 风险评估 模型 盆腔手术 

分 类 号：R713[医药卫生—妇产科学]