Caprini风险评估模型在肺癌手术患者血栓预防中的应用研究

Application of Caprini risk assessment model in prevention of thrombus in patients undergoing lung cancer surgery

目的研究Caprini风险评估模型在肺癌手术患者血栓预防中的应用效果。方法纳入2019年1月至2020年12月嘉兴市第一医院收治的180例肺癌手术患者作为研究样本,经随机数字表法分组,将其中90例作为干预组,接受Caprini血栓风险评估;另90例作为对照组,接受常规血栓风险评估;比较两组血D-二聚体(DD)水平、术后静脉血栓症(VTE)发生率、胸腔引流量、住院时间、住院费用等指标差异。出院前再将经Caprini血栓风险评估工具评估为“高危”的42例干预组患者依照随机数字表法分组,其中21例接受延长干预,为延长组;余下21例不接受延长干预,为非延长组;比较两组出院30 d内的静脉血栓、出血事件发生率。结果干预组DD水平及住院费用低于对照组,胸腔引流量多于对照组,住院时间短于对照组,VTE发生率(1.11%)低于对照组(13.33%),差异有统计学意义(P<0.05);非延长组出院30 d内的出血事件发生率(0)低于延长组(28.57%),且延长组出院30 d内的VTE发生率(0)同样低于非延长组(33.33%),差异有统计学意义(P<0.05)。结论Caprini风险评估模型可较为准确地筛查出肺癌手术患者的血栓发生风险,指导临床落实干预决策,进而改善患者预后,该工具的使用契合新医改精神,值得临床推广。

Objective To study the application effect of Caprini risk assessment model(RAM)in prevention of thrombosis in patients undergoing lung cancer surgery.Methods A total of 180 patients who received lung cancer surgery in the First Hospital of Jiaxing from January 2019 to December 2020 were selected as research objects.They were divided into groups by the random number table method,and 90 of them were included in the intervention group and received Caprini RAM,and another 90 cases were included in the control group and received conventional thrombus risk assessment.The levels of blood D-Dimer(DD),incidence of venous thromboembolism(VTE),thoracic drainage,hospitalization time and hospitalization expenses were compared between the two groups.Before discharge,42 patients in intervention group who were assessed as"high risk"by Caprini RAM were divided into groups according to random number table method,among which 21 patients received extended intervention,which was the extended group.The remaining 21 cases did not receive extended intervention,which was a non-extended group.The incidence of venous thrombosis and bleeding within 30 days after discharge was compared between the two groups.Results DD level,hospitalization expenses,thoracic drainage and hospitalization time in the intervention group were lower and more than those in the control group,and VTE incidence(1.11%)was lower than that in the control group(13.33%),with statistically significant differences(P<0.05).The incidence of bleeding events within 30 days after discharge(0)in the non-extended group was lower than that in the extended group(28.57%),and the incidence of VTE within 30 days after discharge(0)in the extended group was also lower than that in the non-extended group(33.33%),the difference was statistically significant(P<0.05).Conclusion Caprini RAM can accurately screen out the risk of thrombosis in patients undergoing lung cancer surgery,and guide clinical intervention decision-making,thus improving the prognosis of patients.The use of this tool is in line with the spirit of the new medical reform,and is worthy of clinical promotion.