Caprini血栓风险评估模型对妇科四级手术患者术后住院期间下肢深静脉血栓的预测价值

Predictive value of Caprini thrombosis risk assessment model for lower extremity deep vein thrombosis during postoperative hospitalization in patients with grade 4gynecological surgery

目的探讨Caprini血栓风险评估模型对妇科四级手术患者术后住院期间发生下肢深静脉血栓(DVT)的预测价值。方法收集2019年3月至2022年6月于北京市通州区妇幼保健院接受妇科四级手术的126例患者的临床资料,根据术后住院期间是否发生下肢DVT将患者分为病例组(n=28,发生下肢DVT)和对照组(n=98,未发生下肢DVT)。分析Caprini血栓风险评估模型中的相关因素与妇科四级手术患者术后住院期间发生下肢DVT的关系,以及妇科四级手术患者术后住院期间发生下肢DVT的危险因素。采用Caprini血栓风险评估模型对两组患者进行评分及下肢DVT危险度分级,并分析下肢DVT危险度与妇科四级手术患者术后住院期间发生下肢DVT的关系。结果单因素分析结果显示,病例组患者的年龄、体重指数、肥胖患者比例、恶性肿瘤发生率、开腹手术患者比例、手术持续时间、术中出血量、口服避孕药患者比例、下肢水肿发生率均高于对照组患者,差异均有统计学意义(P<0.05)。多因素分析结果显示,年龄≥65岁、恶性肿瘤、肥胖、口服避孕药物均是妇科四级手术患者术后住院期间发生下肢DVT的独立危险因素(P<0.05)。病例组患者术前Caprini血栓风险评估模型评分及下肢DVT危险度均明显高于对照组患者,差异均有统计学意义(P<0.01)。极高危和高危患者下肢DVT的发生率明显高于中低危患者,差异有统计学意义(P=0.004)。结论Caprini血栓风险评估模型对妇科四级手术患者术后住院期间发生下肢DVT具有较高的预测价值。

Objective To evaluate the predictive value of Caprini thrombosis risk assessment model for lower extremity deep vein thrombosis(DVT)during postoperative hospitalization in patients with grade 4 gynecological surgery.Method Clinical data of 126 patients who received grade 4 gynecological surgery in the Tongzhou Maternal and Child Health Care Hospital of Beijing from March 2019 to June 2022 were collected.All patients were divided into case group(n=28,lower extremity DVT)and control group(n=98,without lower extremity DVT)according to occurrence of lower extremity DVT.The relationship of related factors in Caprini thrombosis risk assessment model with occurrence of lower extremity DVT during hospitalization after grade 4 gynecological surgery and risk factors were analyzed.The score and lower extremity DVT risk classification of the two groups were evaluated by Caprini thrombosis risk assessment model and the relationship between the risk classification of lower extremity DVT and the incidence of lower extremity DVT during postoperative hospitalization in patients with grade 4 gynecological surgery.Result The results of single factor analysis show that the age,body mass index,proportion of obese patients,incidence rate of malignancy,proportion of open surgery,surgery duration,intraoperative blood loss,proportion of oral contraceptives use,and incidence rate of lower extremity edema in the case group were higher than those in the control group,the differences were statistically significant(P<0.05).Multivariate analysis showed that age≥65 years old,malignancy,obesity,and oral contraceptives were independent risk factors for lower extremity DVT after grade 4 gynecological surgery(P<0.05).The preoperative score by Caprini thrombosis risk assessment model and risk classification of lower extremity DVT in case group were significantly higher than those in the control group,the differences were statistically significant(P<0.01).The incidence rate of lower extremity DVT of extremely high-risk and high-risk patients was significantly higher than that of low-risk patients,with statistically significant difference(P=0.004).Conclusion The Caprini thrombosis risk assessment model has a high predictive value for the occurrence of lower extremity DVT during postoperative hospitalization in patients with grade 4 gynecological surgery.