新发VTE患者血栓风险分层下的临床特征分析

Analysis of Clinical Characteristics of Newly-onset VTE Patients under Thrombosis Risk Stratifications

目的分析住院新发静脉血栓栓塞症(venous thromboembolism,VTE)患者不同血栓风险分层下的临床相关特征,为VTE的分级临床流程管理建设和完善提供数据支持。方法纳入2017年11月~2018年8月住院后新发生的经下肢血管超声诊断的VTE患者,分析不同血栓初始风险评估分组患者的基本住院信息、血栓形成部位、血栓危险因素、临床检查、临床治疗与预防的特征与差异。结果纳入669例新发VTE患者,661例(98.80%)行血栓初始风险评估。新发VTE患者的初始风险评估分层中,极高危311例(47.05%)、高危284例(42.96%)、中危59例(8.93%)、低危7例(1.06%)。不同风险分组间血栓形成的肢体(Fisher,P=0.35)及解剖部位(χ^(2)=4.28,P=0.90)分布比较,差异均无统计学意义。外科危险分层分布比较,差异有统计学意义(Fisher,P=0.02),其中极高危与高危比较,差异有统计学意义(Fisher,P=0.03)。不同风险分层的VTE患者,在基本住院信息、危险因素、临床检查、预防与治疗管理流程中的多个环节的分布比较,差异有统计学意义(P<0.05)。结论不同VTE风险分层的新发VTE患者临床特征的差异性,可作为血栓风险分级指导下VTE临床管理流程的建设与完善提供数据支持。

Objective To analyze the clinical characteristics of newly-onset VTE patients with different thrombosis risk levels,and to provide quantitative support for the development and improvement of the hierarchical VTE management.Methods Data of new-onset VTE patients in hospital,diagnosed by lower extremity vascular ultrasound,from November 2017 to August 2018 were collected.The basic hospitalization information,thrombosis site,thrombosis risk factors,clinical examination,clinical prevention and treatment were analyzed.Results 699 VTE new patients were investigated,of which 661 cases(98.80%)were evaluated for the thrombosis risk.These patients were classified into different level with regard to their thrombosis risks:311 cases(47.05%)with extremely high risk,284 cases(42.96%)with high risk,59 cases(8.93%)with intermediate risk,and 7 cases(1.06%)with low risk.The distribution discrepancy of the thrombosis sites(Fisher,P=0.35)and the anatomic sites(χ^(2)=4.28,P=0.89)among different risk levels were no statistically significant.The distribution discrepancy of surgical risk stratification(Fisher,P=0.02)is statistically significant,which is reflected by the difference between the extremely high risk level and the high risk level(Fisher,P=0.03).VTE patients with different risk stratifications have statistically significant differences in the distribution of the basic hospitalization information,risk factors,clinical examination,clinical treatment and prevention(P<0.05).Conclusion The differences in newly-onset VTE patients with different VTE risk stratifications can provide data support for the construction and improvement to the VTE clinical management process under the guidance of thrombosis risk classification.