下肢静脉彩超联合改良Caprini评分对BPH围手术期DVT风险的评估和管理

Evaluation and management of DVT risk during the perioperative period of BPH by combining color Doppler ultrasound of lower limbs with modified Caprini score

目的探讨下肢静脉彩超联合改良Caprini评分对良性前列腺增生症(BPH)围术期下肢深静脉血栓(DVT)风险的评估和管理,为临床干预方案制定提供参考。方法选取2015年1月~2018年12月江西省中西医结合医院收治的80例男性BPH患者为研究对象。术前使用改良Caprini评分评估DVT风险并进行分级管理,术后1个月采用下肢静脉彩超探查DVT发生情况。结果80例男性BPH患者中,低危组42例,中危组24例,高危组14例。随访1个月,下肢静脉彩超检查共发生DVT 10例。高危组DVT阳性率高于中危组,改良Caprini评分高于低危组、中危组,DVT发生时间短于中危组,差异有统计学意义(P<0.05);以中度风险(3~4分)为界值评估DVT的灵敏性、特异性均为100%,评估效果较好。结论BPH患者围术期应用改良Caprini风险评估模型筛查DVT可有效预测DVT的发生,且改良Caprini评分以中度风险(3~4分)作为评估界值的价值较高。

Objective To explore the risk assessment and management of deep vein thrombosis(DVT)of lower limbs risk during the perioperative period of benign prostatic hyperplasia(BPH)combined with modified Caprini score,and to provide reference for the formulation of clinical intervention programs.Methods A total of 80 male patients with BPH admitted to Jiangxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2015 to December 2018 were selected as the research objects.The risk of DVT was evaluated by modified Caprini score before the operation and graded management was carried out.1 month after the operation,the occurrence of DVT was detected by lower limb vein color ultrasound.Results Among the 80 male patients with BPH,there were 42 patients in the low-risk group,24 patients in the medium-risk group and 14 patients in the high-risk group.After 1 month of follow-up,10 cases occurred DVT by the examination of color Doppler ultrasound of lower limbs.The positive rate of DVT in the high-risk group was higher than that in the medium-risk group,and the modified Caprini score was higher than that in the low-risk group and the medium-risk group,the occurrence time of DVT was shorter than that in the intermediate-risk group,and the difference were statistically significant(P<0.05).The sensitivity and specificity of DVT were all 100% with the threshold value of moderate risk(3-4 points),and the evaluation effect was relatively good.Conclusion The use of modified Caprini score risk assessment model to screen for DVT in patients with BPH during the perioperative period can effectively predict the occurrence of DVT,and the modified Caprini score has a higher value with moderate risk(3-4 points)as the evaluation threshold.