5种深静脉血栓风险评估工具在脑出血急性期患者中的比较研究

Comparison of five risk assessment tools of deep venous thrombosis in patients with acute intracerebral hemorrhage

目的比较临床上常用的5种深静脉血栓(deep venous thrombosis,DVT)风险评估工具在脑出血急性期患者中的应用价值,筛选出当前更适合的工具,助力医护人员精准识别高危人群。方法采用回顾性研究法,随机选取2020年1~12月在温州医科大学附属第一医院神经内科住院治疗的256例脑出血急性期患者作为研究对象,由研究者分别应用5种DVT风险评估工具(Padua风险评估模型、Caprini风险评估模型、WellsDVT风险评估模型、Autar风险评估模型和急性脑卒中患者DVT风险评估模型)对患者进行评估,用优劣解距离法(technique for order preference by similarity to ideal solution,TOPSIS)对各工具的敏感度、特异性、受试者操作特征(receiveroperatingcharacteristic,ROC)曲线下面积(area under the curve,AUC)、准确率等进行综合比较并排序,筛选出更适合脑出血急性期患者的DVT风险评估工具。结果5种DVT风险评估工具在脑出血急性期患者中的相对接近程度值(Ci)依次为Autar风险评估模型0.681、Padua风险评估模型0.636、Caprini风险评估模型0.385、急性脑卒中患者DVT风险评估模型0.363、Wells DVT风险评估模型0.315。结论通过综合比较发现,在5种DVT风险评估工具中,Autar风险评估模型预测脑出血急性期患者发生DVT风险的效果更优,建议医护人员采用Autar风险评估模型预测脑出血急性期患者发生DVT的风险。

Objective To compare five public deep venous thrombosis(DVT)risk assessment models(RAM)in patients with acute cerebral hemorrhage,and to select one suitable assessment tool,with which medical staff are able to carry out effective individualized prevention accordingly in time.Methods In this retrospective study,256 in-patients with acute cerebral hemorrhage in the Neurology Department of the First Affliated Hospital of Wenzhou Medical University from January to December 2020 were randomly enrolled.The researchers applied five models and record the scores,including Padua RAM,Caprini RAM,Wells DVT RAM,Autar RAM and acute stroke DVT-RAM.The data were summarized and analyzed with SPSS 25.0 and R4.1.The predictive values of above RAMs are compared separately by TOPSIS(technique for order preference by similarity solution)to find out a suitable tool.Results Predictive value(Ci)ranking of five DVT-RAMs,Autar RAM,Padua RAM,Caprini RAM,acute stroke DVT-RAM and Wells DVT RAM,by TOPSIS were 0.681,0.636,0.385,0.363,0.315.Conclusion According to comprehensive comparison by TOPSIS,Autar RAM was the suitable assessment model to assess the DVT risk of patients with acute cerebral hemorrhage.It is suggested that medical staff apply the Autar risk assessment model to predict the risk of DVT in patients with acute cerebral hemorrhage.