Wells量表对脊髓损伤患者下肢深静脉血栓的诊断价值评价

The Value of Wells Score in the Diagnosis of Deep Vein Thrombosis in Spinal Cord Injury Patients

目的:探讨Wells评分对脊髓损伤后下肢深静脉血栓的诊断价值。方法:选取2014年5月至2015年12月于我院康复科初诊的外伤性脊髓损伤患者196例,以下肢深静脉超声作为下肢深静脉血栓的确诊手段,并利用Wells评分对所有患者进行评估。结果:Wells评分在评估脊髓损伤患者康复阶段下肢深静脉血栓中的灵敏度为64.3%,漏诊率为35.7%,特异度为99.3%,误诊率为0.7%,约登指数(Youden's Index)63.6%,阳性预测值为97.3%,阴性预测值为87.4%,阳性似然比为91.9,阴性似然比为0.36。结论:Wells评分诊断脊髓损伤患者下肢深静脉血栓时会出现较高的假阴性,尚不能成为独立预测脊髓损伤患者康复阶段下肢深静脉血栓的有效方法。

Objective:To observe the value of Wells score in diagnosis of deep vein thrombosis after spinal cord injury.Methods:196 patients admitted in our rehabilitation department between May 2014 to December 2015 were obversed.Lower extremity deep venous ultrasonography was carried to diagnosis deep vein thrombosis,and the Wells score was used to evaluate all patients.Results:The Wells score in evaluation of deep venous thrombosis of spinal cord injury patients in rehabilitation stage sensitivity was 64.3%,misdiagnosis rate was 35.7%,and the specificity was 99.3%,and the misdiagnosis rate was 0.7%,the Youden's index was 63.6%,the positive predictive value was 97.3%,the negative predictive value was 87.4%,the positive likelihood ratio is 91.9,negative likelihood ratio was 0.36.Conclusions:There is a higher Wells score of false negative diagnosis of deep venous thrombosis in patients with spinal cord injury.Wells score is not an effective method to evaluating deep venous thrombosis.