Caprini评分联合血清学对妇科恶性肿瘤患者发生下肢深静脉血栓的预测价值  

Prediction value of Caprini score combined with serology for lower extremity deep vein thrombosis in patients with gynecological malignant tumor

作　　者：魏鑫源 王才智 王玲玲 WEI Xinyuan;WANG Caizhi;WANG Lingling(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院妇产科,安徽蚌埠233004

出　　处：《中华全科医学》2025年第3期379-382,442,共5页Chinese Journal of General Practice

基　　金：安徽高校自然科学研究项目(KJ2021A0754)。

摘　　要：目的回顾性分析妇科恶性肿瘤术后发生下肢深静脉血栓(DVT)患者的临床特征及血清学指标,探讨Caprini评分联合术前D-二聚体(D-D)、纤维蛋白原(FIB)对妇科恶性肿瘤患者术后发生下肢DVT的预测价值。方法选取2018年10月-2022年10月在蚌埠医科大学第一附属医院妇科及妇瘤科治疗的恶性肿瘤术后发生下肢DVT的95例患者作为血栓组,以1∶2比例纳入同期入院行手术治疗但未发生DVT的190例妇科恶性肿瘤患者作为非血栓组。比较2组患者的一般资料,分析Caprini评分与术前D-D、FIB的关系,探讨三者联合应用对妇科恶性肿瘤术后发生DVT的预测价值。结果血栓组术后Caprini评分与术前D-D、FIB呈正相关关系(r=0.375、0.426,均P<0.05)。术后Caprini评分、术前D-D、FIB诊断DVT的AUC分别为0.832、0.811、0.782;最佳临界值分别为8.50分、0.54 mg/L、3.26 g/L;灵敏度分别为62.10%、76.80%、69.50%;特异度分别为90.50%、74.70%、77.90%;而术后Caprini评分与术前D-D、FIB联合应用诊断DVT的灵敏度为78.90%,特异度为79.50%,AUC为0.859(P<0.05)。结论妇科恶性肿瘤患者术后Caprini评分与术前D-D、FIB呈正相关关系,当术后Caprini评分≥8.50分且术前D-D≥0.54 mg/L、FIB≥3.26 g/L时,应该高度怀疑DVT。Objective The clinical characteristics and serological indexes of patients with lower extremity deep vein thrombosis(DVT)after surgery for gynecologic malignant tumor are retrospectively analyzed,and the predictive value of Caprini score combined with preoperative D-D and FIB for postoperative DVT in patients with gynecologic malignant tumor is discussed.Methods Ninety-five patients with postoperative DVT of lower limbs who were treated in the Department of Gynecology and Gynecologic Oncology of the First Affiliated Hospital of Bengbu Medical University from October 2018 to October 2022 were selected as the thrombus group,and 190 patients who were admitted for surgical treatment during the same period but did not develop DVT were included as the non-thrombotic group at a ratio of 1∶2.The general data of the two groups were compared,and the relationship between Caprini score and preoperative D-D,FIB was analyzed,and the predictive value of the combined application of the three on postoperative DVT of gynecological malignant tumor was discussed.Results Postoperative Caprini score was positively correlated with preoperative D-D and FIB in thrombus group(r=0.375,0.426,both P<0.05).The AUC of postoperative DVT in patients diagnosed with gynecological malignant tumor by Caprini score,D-D and FIB were 0.832,0.811 and 0.782,respectively.The optimal critical values were 8.50 points,0.54 mg/L and 3.26 g/L,respectively.The sensitivity were 62.10%,76.80%and 69.50%,respectively.The specificity were 90.50%,74.70%and 77.90%,respectively.The sensitivity and specificity of Caprini score combined with D-D and FIB in the diagnosis of postoperative DVT in patients with gynecological malignant tumor were 78.90%,79.50%and 0.859(P<0.05).Conclusion In patients with gynecological malignant tumors,postoperative Caprini score is positively correlated with preoperative D-D and FIB.When postoperative Caprini score is≥8.50 points,preoperative D-D is≥0.54 mg/L and preoperative FIB is≥3.26 g/L,DVT should be highly suspected.

关 键 词：妇科恶性肿瘤 深静脉血栓 Caprini评分 D-二聚体 纤维蛋白原 

分 类 号：R737.3[医药卫生—肿瘤] R543.6[医药卫生—临床医学]