不同血栓风险评估模型对单孔胸腔镜下肺癌根治术后肺栓塞的术前筛查效果

Effect of different thrombotic risk assessment models on preoperative screening of pulmonary embolism after radical thoracoscopic resection of lung cancer

目的探讨不同血栓风险评估模型对单孔胸腔镜下肺癌根治术后肺栓塞的术前筛查效果。方法收集2020年1月至2021年1月新疆医科大学第一附属医院364例接受单孔胸腔镜下肺癌根治术治疗的肺癌患者临床资料。根据术后发生肺栓塞情况分为肺栓塞组(n=26)和非肺栓塞组(n=338)。统计并比较两组患者临床特征、Caprini和Rogers风险评估模型得分;Caprini和Rogers风险评估模型筛查效能采用受试者工作特征(ROC)曲线确定最佳截断点、灵敏度、特异度和曲线下面积(AUC)。结果肺栓塞组患者心房颤动、慢性肾病发生率高于非肺栓塞组患者,住院时间长于非肺栓塞组患者,Caprini评分和Rogers评分高于非肺栓塞组患者,差异有统计学意义(P<0.05)。Caprini风险评估模型筛查根治术后肺栓塞发生的AUC为0.962(95%CI:0.931~0.994),具有较高筛查价值,最佳截断点为3.780分,灵敏度84.615%,特异度95.562%;Rogers风险评估模型筛查根治术后肺栓塞发生的AUC为0.863(95%CI:0.796~0.929),具有中等筛查价值,最佳截断点为2.185分,灵敏度76.923%,特异度79.882%。结论Caprini风险评估模型对单孔胸腔镜下肺癌根治术后肺栓塞的术前筛查具有更高价值,灵敏度和特异度均更高。

Objective To study the preoperative screening effect of different thrombotic risk assessment models on preoperative screening of pulmonary embolism after radical thoracoscopic resection of lung cancer.Method Data of 364 patients with lung cancer who received single-port thoracoscopic radical resection of lung cancer in First Affiliated Hospital of Xinjiang Medical University from January 2020 to January 2021 were retrospectively analyzed.According to the occurrence of pulmonary embolism after operation,they were divided into pulmonary embolism group(n=26)and non-pulmonary embolism group(n=338).The clinical characteristics,Caprini and Rogers risk assessment model scores of the two groups were counted and compared.The screening efficiency of Caprini and Rogers risk assessment model used the receiver operating characteristic(ROC)curve to determine the best cut-off point,sensitivity,specificity and area under the curve(AUC).Result The incidence of central atrial fibrillation,chronic kidney disease and adenocarcinoma of histological type in pulmonary embolism group was higher than that in non-pulmonary embolism group,and the mean length of hospital stay in pulmonary embolism group was longer than that in non-pulmonary embolism group,with statistical significance(P<0.05).The AUC of Caprini risk assessment model for screening pulmonary embolism after radical resection was 0.962(95%CI:0.931-0.994),which had high screening value.The best cut-off point was 3.780,the sensitivity was 84.615%,and the specificity was 95.562%.The AUC of Rogers risk assessment model for screening pulmonary embolism after radical resection was 0.863(95%CI:0.796-0.929),which had medium screening value.The best cutoff point was 2.185,the sensitivity was 76.923%,and the specificity was 79.882%.Conclusion Compared with Rogers,Caprini thrombosis risk model has higher screening value,higher sensitivity and specificity for pulmonary embolism after single-port thoracoscopic radical resection of lung cancer.