简化电子化Caprini风险评估对ICU病人深静脉血栓形成预防的效果分析

Effect analysis of electronic simplified Caprini risk assessment in the prevention of deep venous thrombosis in ICU patients

目的:探讨电子化简化Caprini风险评估对预防ICU病人深静脉血栓形成(DVT)的效果。方法:基于中华医学会血栓栓塞性疾病防治委员会建议和ACCP-9指南,分别设计出血风险评估、简化电子化Caprini风险评估量表纳入医院电子病历信息化系统,2014年9月至2015年6月对50例ICU病人(评估组)进行出血风险、简化电子化Caprini风险评估,根据出血风险因素、风险评估等级采取针对性预防措施。同时回顾性调查2013年9月至2014年9月50例ICU住院病人(未评估组)DVT预防情况。结果:采用简化电子化Caprini风险评估后ICU危重病人DVT预防率为100%,其中物理预防从20%提高到76%,药物预防和联合预防基本持平,评估组和未评估组病人比较DVT预防率差异有统计学意义(P<0.01)。未评估前的50例病人发生2例猝死,采用风险评估后的50例病人无一例猝死发生。结论:采用基于循证的简化电子化Caprini风险评估可提高ICU危重病人DVT预防率,但仍需要进行持续质量改进,以不断提高医疗护理质量。

Objective： To explore the effects of electronic simplified Caprini risk assessment in the prevention of deep venous thrombosis（ DVT） in ICU patients. Methods： According to the Chinese medical association thromboembolic disease prevention and control committee suggestion and ACCP-9（ American College of Chest Physicians） guideline,the electronic bleeding risk assessment table and electronic simplified Caprini risk assessment table were designed and applied in the hospital electronic medical records information system. Fifty patients in ICU from September 2014 to June 2015 were assessed using the electronic bleeding risk assessment table and electronic simplified Caprini risk assessment table,and the DVT was prevented according to the assessment results. The DVT prevention data of 50 ICU patients without assessment from September 2013 to Septenber 2014 were retrospectively analyzed. Results：The prevention rate of DVT in ICU critical patients assessed by electronic simplified Caprini risk assessment was 100%,the physical prevention rate increased from 20% to 76%,the prevention rate of drug was similar to the combination prevention,and the difference of the prevention rate of DVT between assessment group and non-assessment group was statistically significant（ P〈0. 01）. Two cases in 50 cases before assessment died suddenly,and none in 50 cases after assessment died suddenly. Conclusions： The electronic simplified Caprini risk assessment based on evidence can increase the prevention rate of DVT in ICU patients,the quality of which still need to be continuously improved to improve the quality of medical care.