Caprini静脉血栓栓塞风险评估指导低分子肝素用于妊娠期女性的效果及对静脉血栓的防治作用

Effect of Caprini Venous Thromboembolism Risk Assessment Guiding Low Molecular Weight Heparin in Pregnant Women and Its Role in the Prevention and Treatment of Venous Thrombosis

目的 探讨Caprini静脉血栓栓塞风险评估指导低分子肝素用于妊娠期女性的效果及对静脉血栓的防治作用。方法 选择2022年1月至2023年4月暨南大学附属顺德医院收治的200例有静脉血栓栓塞(VTE)风险的妊娠期妇女,随机分观察组与对照组,各100例。对照组按照科室既往患者管理策略进行管理,观察组严格采用Caprini模型对VTE风险进行评估分级并给予相应措施。比较两组临床资料,包括年龄、体质量指数、孕次、高血压、糖尿病、VTE家族史、C-反应蛋白(CRP)、血小板计数(PLT)。记录比较两组妊娠期、产后3个月内、产后12个月内VTE发生率、出血并发症发生率。通过三水平五维健康量表(EQ-5D-3L)评估妊娠期、产后第3个月、产后第12个月时血栓高危孕妇的生活质量。结果 两组妊娠期、产后3个月内、产后12个月内VTE发生率比较差异无统计学意义(P> 0.05)。两组妊娠期出血并发症发生率比较差异无统计学意义(P> 0.05),观察组产后3个月内、产后12个月内出血并发症发生率低于对照组,差异有统计学意义(P <0.05)。观察组血栓高危孕妇妊娠期时EQ-5D-3L评分为(6.11±1.05)分,产后第3个月EQ-5D-3L评分为(8.09±1.37)分,产后第12个月EQ-5D-3L评分为(9.13±0.52)分,不同时点间EQ-5D-3L评分比较差异有统计学意义(P <0.05)。观察组产后第3个月及第12个月EQ-5D-3L评分均高于对照组,差异有统计学意义(P <0.05)。结论 Caprini风险评估模型可预防VTE发生,降低出血并发症发生率,并提高产后生活质量。

Objective To explore the effect of Caprini venous thromboembolism(VTE)risk assessment guiding low molecular weight heparin in pregnant women and its role in the prevention and treatment of venous thrombosis.Methods A total of 200 pregnant women with VTE risk admitted to Shunde Hospital,Affiliated to Jinan University,from January 2022 to April 2023 were selected and randomly divided into an observation group and a control group,with 100 cases in each group.The control group was managed according to the previous patient management strategies of the department,while the observation group strictly used the Caprini model to assess and grade VTE risk and took corresponding measures.Clinical data,including age,body mass index,number of pregnancies,hypertension,diabetes,family history of VTE,C-reactive protein(CRP),and platelet count(PLT),were compared between the two groups.The incidence of VTE during pregnancy,within 3 months postpartum,and within 12 months postpartum,as well as the incidence of bleeding complications,were recorded and compared.The quality of life of high-risk pregnant women was assessed using the European Quality of Life 5 Dimensions 3 Level Version(EQ-5D-3L)during pregnancy,at 3 months postpartum,and at 12 months postpartum.Results There was no statistically significant difference in the incidence of VTE during pregnancy,within 3 months postpartum,and within 12 months postpartum between the two groups(P>0.05).There was no statistically significant difference in the incidence of bleeding complications during pregnancy between the two groups(P>0.05).The incidence of bleeding complications within 3 months postpartum and within 12 months postpartum in the observation group was lower than that in the control group,with statistically significant differences(P<0.05).The EQ-5D-3L scores of high-risk pregnant women in the observation group were(6.11±1.05)during pregnancy,(8.09±1.37)at 3 months postpartum,and(9.13±0.52)at 12 months postpartum.The differences in EQ-5D-3L scores at different time points were statistically significant(P<0.05).The EQ-5D-3L scores at 3 months and 12 months postpartum in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion The Caprini risk assessment model can prevent the occurrence of VTE,reduce the incidence of bleeding complications,and improve the quality of life postpartum.