Caprini血栓风险评估量表对泌尿外科患者术后下肢深静脉血栓形成的评估价值  

The value of Caprini risk assessment scale in the evaluation of deep vein thrombosis of lower extremities in patients after urological surgery

作　　者：徐子航 郝斌[2] 尚吉文[3] 张建陶[2] 赵斌亮[2] 焦乐 姚杰[2] 游彤辉 杨涛[2] Xu Zihang;Hao Bin;Shang Jiwen;Zhang Jiantao;Zhao Binliang;Jiao Le;Yao Jie;You Tonghui;Yang Tao(Graduate School,Bethune Hospital Affiliated to Shanxi Medical University,Taiyuan 030032,China;Department of Vascular Surgery,Bethune Hospital Affiliated to Shanxi Medical University,Taiyuan 030032,China;Department of Urinary Surgery,Bethune Hospital Affiliated to Shanxi Medical University,Taiyuan 030032,China)

机构地区：[1]山西医科大学附属白求恩医院研究生院,太原030032 [2]山西医科大学附属白求恩医院血管外科,太原030032 [3]山西医科大学附属白求恩医院泌尿外科,太原030032

出　　处：《中国血管外科杂志（电子版）》2020年第4期310-313,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：山西省软科学研究计划项目(2018041030-5)。

摘　　要：目的验证Caprini血栓风险评估量表对泌尿外科患者术后下肢深静脉血栓形成(deep vein thrombosis,DVT)发生的评估价值。方法采用病例对照研究连续收集2015年1月至2017年12月山西白求恩医院泌尿外科术后确诊的53例症状性DVT患者作为病例组,随机选择同期入院的106例泌尿外科术后未发生DVT患者作为对照组。依据Caprini量表对患者进行评分及静脉血栓栓塞症(venous thromboembolism,VTE)危险度分级并进行比较,采用多因素Logistic回归对Caprini量表的危险因素进行分析。结果病例组患者Caprini评分高于对照组[(7.66±3.17)分vs(5.19±2.29)分],经Caprini量表评定为高危的比例高于对照组(86.8%vs 58.5%),差异均有统计学意义(P<0.05)。Caprini量表预测术后患者DVT发生的曲线下面积为0.740(95%CI=0.657~0.822,P<0.001)。Caprini量表评估的高危组泌尿外科患者术后DVT发病风险是低危患者的8.903倍。Caprini量表中的恶性肿瘤、下肢肿胀(现患)、VTE病史、多发性创伤(<1个月)、大型开放手术(≥45min)是泌尿外科患者术后DVT发生的危险因素。结论Caprini血栓风险评估量表对泌尿外科患者术后DVT的发生具有良好的预测价值。Objective To verify the value of Caprini risk assessment scale in the evaluation of deep vein thrombosis(DVT)of lower extremities in patients after urologic surgery.Methods A case-control study was conducted to continuously collect 53 patients with symptomatic DVT diagnosed after urologic surgery in Shanxi Bethune Hospital from January 2015 to December 2017 as the case group,and 106 patients who were admitted to the hospital during the same period without DVT after urology surgery were randomly selected as the case group.Patients were scored according to the Caprini scale and the risk of venous thromboembolism(VTE)was graded and compared.Multivariate Logistic regression was used to analyze the risk factors of the Caprini scale.Results The Caprini score of the case group was higher than the control group[(7.66±3.17)vs(5.19±2.29)],and the proportion of patients rated as high-risk by the Caprini scale was higher than control group(86.8%vs 58.5%).The differences were statistically significant(P<0.05).The area under curve predicted by the Caprini scale for the occurrence of DVT in patients after surgery was 0.740(95%CI=0.657~0.822,P<0.001).The postoperative DVT risk of high-risk group assessed by Caprini scale in urology patients was 8.903 times higher than low-risk group.In the Caprini scale elements,malignant tumors,existing lower extremity swelling,VTE history,multiple trauma(<1 month)and major open surgery(≥45min)were the risk factors for DVT after urology surgery.Conclusion The Caprini risk assessment scale has a good predictive value for the occurrence of postoperative DVT in urological patients.

关 键 词：泌尿外科手术 深静脉血栓形成 Caprini血栓风险评估量表 

分 类 号：R699[医药卫生—泌尿科学] R543.6[医药卫生—外科学]