Caprini血栓风险评估量表对血液透析患者AVG手术后血栓事件的预测价值  

The value of Caprini thrombosis risk assessment scale for the prediction of thrombosis events in hemodialysis patients after arteriovenous graft surgery

作　　者：姚瑶[1] YAO Yao(Department of Orthopedics,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院骨科关节老年病区,乌鲁木齐830001

出　　处：《中国血液净化》2024年第5期382-386,共5页Chinese Journal of Blood Purification

摘　　要：目的探讨Caprini血栓风险评估量表对血液透析患者移植物动静脉内瘘(arteriovenous graft,AVG)手术后血栓事件及6个月内初级通畅率的预测价值。方法回顾性分析2017年10月—2023年01月新疆维吾尔自治区人民医院收治的终末期肾病拟行AVG的患者,收集患者的一般资料、手术资料、手术后6个月的内瘘通畅率。专科护士通过患者住院期间Caprini评分结果,将患者分为:A组(低危患者)、B组(中危患者)、C组(高危与极高危患者),比较3组患者的一般资料及手术中资料;通过Kaplan-Meier对比分析3组患者手术后6个月内的内瘘通畅率;通过COX模型分析相关危险因素。结果共纳入52例患者,其中男性30例,女性22例;平均年龄(54.75±12.68)岁。3组间年龄、D-二聚体水平比较差异有统计学意义(Z=5.836,P=0.005;Z=4.009,P=0.024)。3组间住院天数、随访时间比较差异有统计学意义(Z=4.432,P=0.017;Z=7.155,P=0.002)。3组患者手术后6个月内通畅率无明显差异(χ^(2)=1.851,P=0.396)。COX回归分析显示年龄(OR=1.015,95%CI:0.943~1.092,P=0.695)、住院天数(OR=0.970,95%CI:0.743~1.265,P=0.820)、D-二聚体(OR=1.029,95%CI:0.594~1.782,P=0.920)、Caprini评分危险程度(OR=1.969,95%CI:0.270~14.367,P=0.504)等因素均对手术后初级通畅率的影响无统计学意义。结论Caprini血栓风险评估量表对终末期肾病患者AVG手术后血栓形成的评估可能缺乏客观的临床证据。Objective To explore the value of Caprini thrombosis risk assessment scale for the prediction of thrombosis events and primary patency rate within 6 months after arteriovenous graft(AVG)surgery in hemodialysis patients.Method A retrospective study was conducted on patients with end-stage renal disease and subjected to AVG surgery from October 2017 to January 2023.General information,surgical data and postoperative patency within 6 months were collected.Patients were divided by professional nurses into group A(low risk patients),group B(medium risk patients),and group C(high and extremely high risk patients)based on the Caprini score during hospitalization.General and intraoperative data were compared among the three groups.Kaplan-Meier survival curve was used to analyze the patency rate within 6 months after surgery in the three groups of patients.COX model was used to analyze the related risk factors.Result A total of 52 patients were recruited in this study,including 30 males and 22 females and with the average age of 54.75±12.68 years old.Age(Z=5.836,P=0.005),D-dimer(Z=4.009,P=0.024),hospitalization day(Z=4.432,P=0.017)and follow-up period(Z=7.155,P=0.002)were statistically different but patency rate within 6 months after the surgery(χ^(2)=1.851,P=0.396)had no difference among the three groups.COX regression demonstrated that age(OR=1.015,95%CI:0.943~1.092,P=0.695),hospitalization day(OR=0.970,95%CI:0.743~1.265,P=0.820),D-dimer(OR=1.029,95%CI:0.594~1.782,P=0.920),and Caprini score(OR=1.969,95%CI:0.270~14.367,P=0.504)were not related to postoperative primary patency rate.Conclusion The Caprini thrombosis risk assessment scale may lack the objective clinical evidence for evaluating thrombosis events in patients with end-stage renal disease after AVG surgery.

关 键 词：Caprini血栓风险评估量表 血液透析 移植物动静脉内瘘 血栓事件 预测价值 

分 类 号：R318.16[医药卫生—生物医学工程]