不同血栓风险评估模型预测经宫腔镜子宫肌瘤切除患者术后深静脉血栓形成的临床价值比较  

Comparison of the clinical value of different thrombus risk assessment models in predicting deep vein thrombosis of patients after transcervical resection of myoma

作　　者：刘秋瑾[1] 张凯[1] 刘红杰 邵勇[1] LIU Qiujin;ZHANG Kai;LIU Hongjie;SHAO Yong(Department of Critical Care Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州大学第三附属医院重症医学科,河南郑州450000

出　　处：《新乡医学院学报》2022年第1期19-24,共6页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:2018020204)。

摘　　要：目的比较新型G-Caprini血栓风险评估模型与Rogers血栓风险评估模型对经宫腔镜子宫肌瘤切除术(TCRM)患者术后深静脉血栓形成(DVT)的预测价值。方法选择2018年1月至2019年12月在郑州大学第三附属医院行TCRM治疗的80例患者为研究对象,根据其术后是否发生DVT分为DVT组(n=35)和无DVT组(n=45),采用单因素和多因素logistic回归分析患者行TCRM后发生DVT的影响因素。采用新型G-Caprini和Rogers血栓风险评估模型对2组患者术后发生DVT的风险进行评估。采用受试者工作特征(ROC)曲线分析新型G-Caprini和Rogers血栓风险评估模型预测患者行TCRM后发生DVT的价值。结果2组患者的年龄、体质量指数与子宫肌瘤患者行TCRM后发生DVT无关(P>0.05),合并肺部疾病、卧床时间、下肢水肿、中心静脉置管、DVT或肺栓塞病史、恶性肿瘤病史与子宫肌瘤患者行TCRM后发生DVT有关(P<0.05)。多因素logistic回归分析结果显示,合并肺部疾病、卧床时间、下肢水肿、中心静脉置管、DVT或肺栓塞病史、恶性肿瘤病史是子宫肌瘤患者行TCRM后发生DVT的独立危险因素(P<0.05)。新型G-Caprini血栓风险评估模型中DVT组患者累计血栓风险评分显著高于无DVT组患者(P<0.05);82.86%的DVT患者被归为高风险,15.56%的无DVT患者被归为高风险,DVT患者被归为高风险的比率显著高于无DVT患者(χ^(2)=7.385,P<0.05)。Rogers血栓风险评估模型中DVT组患者累计风险评分显著高于无DVT组患者(P<0.05);60.00%的DVT患者被归为高风险,33.33%的无DVT患者被归为高风险,DVT患者被归为高风险的比率显著高于无DVT患者(χ^(2)=5.321,P<0.05)。80例患者中,36例被新型G-Caprinis血栓风险评估模型评估为高风险人群,44例被评估为非高风险人群;36例被评估为高风险人群的患者中有29例发生DVT,44例评估为非高风险人群的患者中有37例未发生DVT,评估准确率为82.50%(66/80)。80例患者中,36例被Rogers血栓�Objective To compare the value of new G-Caprini thrombus risk assessment model and Rogers thrombus risk assessment model in predicting deep vein thrombosis(DVT)of patients after transcervical resection of myoma(TCRM).Methods Eighty patients who underwent TCRM in the Third Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were selected as the research objects.The patients were divided into DVT group(n=35)and non-DVT group(n=45)according to whether DVT occurred after operation.The factors influencing DVT after TCRM were analyzed by single factor and multiple factor logistic regression analysis.The new G-Caprini and Rogers thrombus risk assessment models were used to assess the risk of postoperative DVT of patients in the two groups.The receiver operating characteristic(ROC)curve was used to analyze the value of new G-Caprini and Rogers risk assessment model in the assessment of DVT of patients after TCRM.Results The age,body mass index of patients were not related to DVT after TCRM(P>0.05);the combination of pulmonary disease,bed time,lower extremity edema,retention of central vein catheter,history of DVT or pulmonary embolism,history of malignant tumor were related to DVT after TCRM(P<0.05).Multivariate logistic regression analysis showed that the combination of pulmonary disease,bed time,lower extremity edema,retention of central vein catheter,history of DVT or pulmonary embolism,history of malignant tumor were independent risk factor of DVT of patients after TCRM(P<0.05).In the new G-Caprini risk assessment model,the cumulative risk score of patients in the DVT group was significantly higher than that in the non-DVT group(P<0.05).Twenty-nine(82.86%)patients with DVT were classified as high risk,7(15.56%)patients without DVT were classified as high risk;the rate of patients with DVT classified as high risk was significantly higher than that of patients without DVT(χ^(2)=7.385,P<0.05).In the Rogers risk assessment model,the cumulative risk score of patients in the DVT group was higher

关 键 词：新型G-Caprini血栓风险评估模型 Rogers血栓风险评估模型 子宫肌瘤 深静脉血栓形成 

分 类 号：R473.71[医药卫生—护理学]