Padua风险评估模型在预防内科住院患者静脉血栓栓塞症中的应用

Validate Padua prediction score＇s ability to predict the risk of venous thromboembolism in medical inpatients

目的探讨Padua风险评估模型在预防内科住院患者静脉血栓栓塞中的作用。方法采用横断面调查研究方法，选择2017年6—8月住院的内科患者3990例，应用Padua风险评估模型筛查静脉血栓栓塞症（VTE）高危患者。结果3990例被调查的内科住院患者中，血栓高危患者为757例，发生率为18．97％。呼吸科、内分泌科、神经内科、肾内科、消化内科、心血管内科、血液内科、肿瘤化疗科血栓栓塞高危患者例数分别为158例占32．18％，48例占7．00％，91例占20．31％，102例占18．58％，41例占8．63％，139例占29．45％，69例占17．12％，109例占23．40％。11项高危因素中血栓高危发生率分别为246例占32．5％，58例占7．66％，531例占70．15％，4例占0．53％，92例占12．15％，493例占64．99％，74例占9．78％，89例占11．76％，131例占17．31％，25例占3．30％，72例占9．51％。年龄≥70岁与〈70岁高危患者发生率差异有统计学意义（χ2=952．20，P=0．oo），活动降低与未降低2组高危患者发生率差异有统计学意义（r=1832．28，P=-0．00）。结论内科住院患者VTE发生率高，不同科室高危VTE发生率不同，Padua风险评估模型简单易用，且明确了应特殊关注的VTE患者人群，对内科住院患者的早起筛查和预防具有重要意义。

Objective To explore the Padua risk assessment model for the application of the prevention of VTE in medical inpatients. Methods A cross-sectional surgery research method was used. A total of 3 990 patients were interviewed of a hospital between June and August in 2017. The Padua assessment model was used to screen patients for VTE risk assessment. Results 3990 patients were interviewed, in which, a high VTE risk was found in 757 cases, accounting for 18.97%. The number and ratio of patients with high risk of VTE in Respiration department （158/32.18%）, Endocrinology department （48/7.00%）, Neurology department （91/20.31%）, Nephrology department （102/18.58%）, Gastroenterology epartment （41/8.63%）, Cardiology department （139/29.45%）, Hematology department （69/ 17.12%） and Medical oncology department （109/23.40%）. Patients with high risk VTE in 11 risk factors were （246/ 32.5%）, （58/7.66%）, （531/70A5%）, （4/0.53%）, （92/12.15%）, （493/64.99%）, （74/9.78%）, （89/11.76%）, （131/17.31%）, （25/3.30%）, （72/9.51%）, two groups compare between age≥70 and 〈70 was statistically significant （χ2=952.20, P=0.00）, two group compare between mobility and reduced mobility was statistically significant （χ2=1832.28, P=0.00）. Conclusions Medical inpatients have a high risk of VTE, it is suggested that include VTE jn clinical quality evaluation standard, establish an effective system of VTE risk management. The Padua risk assessment model has been easy to use. Some medical department should be special attention, and has been great significance to early screening and prevention.