Efficacy of percutaneous mechanical thrombus removal in acute lower extremity deep venous thrombosis

BACKGROUND Acute lower extremity deep venous thrombosis(LEDVT)is a common vascular emergency with significant morbidity risks,including post-thrombotic syndrome(PTS)and pulmonary embolism.Traditional treatments like catheter-directed thrombolysis(CDT)often result in variable success rates and complications.AIM To investigate the therapeutic efficacy of percutaneous mechanical thrombus removal in acute LEDVT.METHODS A retrospective analysis was performed to examine 58 hospitalised patients with acute LEDVT between August 2019 and August 2022.The patients were categorised into the percutaneous mechanical thrombectomy(PMT)group(n=24)and CDT group(n=32).The follow-up,safety and treatment outcomes were compared between the two groups.The main observational indexes were venous patency score,thrombus removal effect,complications,hospitalisation duration and PTS.RESULTS The venous patency score was 9.04±1.40 in the PMT group and 8.81±1.60 in the CDT group,and the thrombus clearance rate was 100%in both groups.The complication rate was 8.33%in the PMT group and 34.84%in the CDT group,and the difference was statistically significant(P<0.05).The average hospitalisation duration was 6.54±2.48 days in the PMT group and 8.14±3.56 days in the CDT group.The incidence of PTS was lower in the PMT group than in the CDT group;however,the difference was not statistically significant(P<0.05).CONCLUSION Compared with CDT,treatment of LEDVT via PMT was associated with a better thrombus clearance rate,clinical therapeutic effect and PTS prevention function,but the difference was not statistically significant.Moreover,PMT was associated with a reduced urokinase dosage,shortened hospitalisation duration and reduced incidence of complications,such as infections and small haemorrhages.These results indicate that PMT has substantial beneficial effects in the treatment of LEDVT.

Establishment of a nomogram model for predicting therapy complications in patients with polycythemia and deep venous thrombosis

BACKGROUND Patients with deep venous thrombosis(DVT)residing at high altitudes can only rely on anticoagulation therapy,missing the optimal window for surgery or thrombolysis.Concurrently,under these conditions,patient outcomes can be easily complicated by high-altitude polycythemia(HAPC),which increases the difficulty of treatment and the risk of recurrent thrombosis.To prevent reaching this point,effective screening and targeted interventions are crucial.Thus,this study analyzes and provides a reference for the clinical prediction of thrombosis recurrence in patients with lower-extremity DVT combined with HAPC.AIM To apply the nomogram model in the evaluation of complications in patients with HAPC and DVT who underwent anticoagulation therapy.METHODS A total of 123 patients with HAPC complicated by lower-extremity DVT were followed up for 6-12 months and divided into recurrence and non-recurrence groups according to whether they experienced recurrence of lower-extremity DVT.Clinical data and laboratory indices were compared between the groups to determine the influencing factors of thrombosis recurrence in patients with lowerextremity DVT and HAPC.This study aimed to establish and verify the value of a nomogram model for predicting the risk of thrombus recurrence.RESULTS Logistic regression analysis showed that age,immobilization during follow-up,medication compliance,compliance with wearing elastic stockings,and peripheral blood D-dimer and fibrin degradation product levels were indepen-dent risk factors for thrombosis recurrence in patients with HAPC complicated by DVT.A Hosmer-Lemeshow goodness-of-fit test demonstrated that the nomogram model established based on the results of multivariate logistic regression analysis was effective in predicting the risk of thrombosis recurrence in patients with lowerextremity DVT complicated by HAPC(χ^(2)=0.873;P>0.05).The consistency index of the model was 0.802(95%CI:0.799-0.997),indicating its good accuracy and discrimination.CONCLUSION The column chart model for the personalized prediction of thrombotic recurrence risk has good application value in predicting thrombotic recurrence in patients with lower-limb DVT combined with HAPC after discharge.

Clinical Value of Predictive Nursing Intervention on Deep Venous Thrombosis of Lower Extremities after Cesarean Section

[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation.

Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients

Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results：Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion：Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

Acute deep venous thrombosis induced by May-Thurner syndrome after spondylolisthesis surgery:A case report and review of literature

BACKGROUND Deep venous thrombosis(DVT)is a serious complication of lumbar spine surgery.Current guidelines recommend pharmacomechanical prophylaxis for patients at high risk of DVT after spine surgery.May-Thurner syndrome(MTS),a venous anatomical variation that may require invasive intervention,is an often overlooked cause of DVT.To date,no case reports of symptomatic MTS caused by isthmic spondylolisthesis or subsequent acute DVT after posterior lumbar surgery have been published.CASE SUMMARY We here present a case of a patient who developed acute DVT 4 h after spondylolisthesis surgery,and MTS was only considered after surgery,during a review of a gynecological enhanced computed tomography image taken before the procedure.CONCLUSION In conclusion,clinicians should consider MTS in the presence of a dangerous triad:spondylolisthesis,elevated D-dimer levels,and sonographically indicated unilateral deep vein dilation.Consultation with a vascular surgeon is also essential to MTS management.

Clinical Application of Percutaneous Transluminal Angioplasty and Stent Implantation in Acute Lower Extremity Deep Venous Thrombosis

Purpose: To analyze the application of percutaneous transluminal angioplasty and stenting in acute deep venous thrombosis of lower extremities. Methods: 70 patients were divided into two groups according to the presence or absence of percutaneous transluminal angioplasty and stenting. Results: The mean circumferential diameter difference between the affected limbs and the healthy limbs and the knees at 15 cm was statistically significant. The cure rate and effective rate of the research group were higher than those of the control group (P<0.05). Conclusion: Percutaneous transluminal angioplasty and stenting are of high value in acute lower extremity deep venous thrombosis.

Discussion on Prevention and Treatment of Lower Extremity Deep Venous Thrombosis in Orthopedic Perioperative Period from Spleen and Stomach Meridians

Deep venous thrombosis of lower extremity is one of the common complications in orthopedic perioperative period.It is caused by many factors,such as peripheral vein dilation,slow blood flow;long-term immobilization,bed rest and so on.On the one hand,it affects the early postoperative functional exercise and functional recovery,on the other hand,it increases the length of hospital stay and economic burden,increases the pain of patients and even endangers their lives.Effective treatment of traditional Chinese medicine combined with western medicine can play a better role in the prevention and treatment of lower extremity deep venous thrombosis.This study expounds the concept of spleen and stomach meridians in the prevention and treatment of lower extremity deep venous thrombosis,and puts forward some opinions on the dialectical treatment and daily conditioning of lower extremity deep venous thrombosis,hoping to provide ideas for the clinical prevention and treatment of lower extremity deep venous thrombosis in traditional Chinese medicine.

Manual aspiration thrombectomy for acute and subacute inferior vena cava thrombosis and lower extremity deep venous thrombosis

Deep vein thrombosis(DVT), which can lead to pulmonary embolism(PE), is a major contributor to the global disease burden and is the third most common cardiovascular pathology after coronary artery disease and stroke. Venous thromboembolic disease, which encompasses the disease entities of DVT and PE, affects up to 10 million cases every year and represents a serious and potentially life-threatening condition. Standard anticoagulation therapy alone is ineffective at promoting deep venous system thrombus removal. Many patients develop postthrombotic syndrome(PTS) despite being on adequate anticoagulation therapy. Aggressive therapy for rapid thrombus removal is important to prevent the development of PTS. Besides impeding the onset of PTS, rapid clearance of the thrombus is also required in the treatment of phlegmasia cerulea dolens, an uncommon but life-threatening complication of acute DVT that can lead to arterial insufficiency, compartment syndrome, venous gangrene, and limb amputation. Manual aspiration thrombectomy(MAT) can provide rapid and effective therapy that could be compared to the open surgical thrombectomy approach with minimal risk of morbidity, mortality, or recurrence after surgery. Though many devices have been developed to date for pharmacomechanical thrombolysis, the cost of the treatment using these devices is very expensive. MAT is simple to perform, easy to learn, inexpensive, and rapid. This review will outline and dissect several studies and case reports, sourced from the Pub Med database, on the subject of the use of MAT in treating inferior vena cava thrombosis and lower extremity DVT, including in patients with compression of the iliac vein and phlegmasia cerulea dolens.

Diagnosis of deep vein thrombosis,and prevention of deep vein thrombosis recurrence and the post-thrombotic syndrome in the primary care medicine setting anno 2014

The requirement for a safe diagnostic strategy of deep vein thrombosis(DVT) should be based on an overall objective post incidence of venous thromboembolism(VTE) of less than 1% during 3 mo fol low-up. Compression ultrasonography(CUS) of the leg veins has a negative predictive value(NPV) of 97%-98% indicating the need of repeated CUS testing within one week. A negative ELISA VIDAS safely excludes DVT and VTE with a NPV between 99% and 100% at a low clinical score of zero. The combination of low clinical score and a less sensitive D-dimer test(Simplify) is not sensitive enough to exclude DVT and VTE in routine daily practice. From prospective clinical research studies it may be concluded that complete recanalization within 3-6 mo and no reflux is associated with a low or no risk of PTS obviating the need of MECS 6 mo after DVT. Partial and complete recanalization after 6 to more than 12 mo is usually complicated by reflux due to valve destruction and symptomatic PTS. Reflux seems to be a main determinant for PTS and DVT recurrence, the latter as a main contributing factor in worsening PTS. This hypothesis is supported by the relation between the persistent residual vein thrombosis(RVT = partial recanalization) and the risk of VTE recurrence in prospective studies. Absence of RVT at 3 mo postDVT and no reflux is predicted to be associated with no recurrence of DVT(1.2%) during follow-up obviating the need of wearing medical elastic stockings and anticoagulation at 6 mo post-DVT. The presence or absence of RVT but with reflux at or after 6 mo postDVT is associated with both symptomatic PTS and an increased risk of VTE recurrence in about one third in the post-DVT period after regular discontinuation of anticoagulant treatment. To test this hypothesis we designed a prospective DVT and postthrombotic syndrome(PTS) Bridging the Gap Study by addressing at least four unanswered questions in the treatment ofDVT and PTS.Which DVT patient has a clear indication for long-term compression stocking therapy to prevent PTS after the initial anticoagulant treatment in the acute phase of DVT?Is 6 mo the appropriate point in time to determine candidates at risk to develop DVT recurrence and PTS?Which high risk symptomatic PTS patients need extended anticoagulant treatment?

Two-point compression ultrasonography: Enough to rule out lower extremity deep venous thrombosis?

BACKGROUND: Deep venous thrombosis(DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department(ED). Point-of-care two-point compression ultrasonography has evolved as a quick and effective way of diagnosing DVT. The purpose of this study is to validate the prevalence and distribution of venous thrombi isolated to proximal lower extremity veins, other than common femoral and popliteal veins in patients with DVT.METHODS: This is a single-center retrospective study that looked at patients presenting to the ED of a tertiary care hospital between January 2014 and August 2018. The clinical presentation and laboratory and imaging results were obtained using the hospital's electronic medical record.RESULTS: A total of 2,507 patients underwent a lower extremity duplex ultrasound during the study period. Among them, 379(15%) were included in the study. The percentages of isolated thrombi to the femoral vein and deep femoral vein were 7.92% and 0.53%, respectively. When the patients were stratified into the two groups of isolated DVT and two-point compression DVT, there were no statistically significant differences in the laboratory results between both groups. However, immobilized patients and patients with recent surgeries were more likely to have an isolated DVT.CONCLUSIONS: Thrombi isolated to proximal lower extremity veins other than the common femoral and popliteal veins make up 8.45% of DVTs. Given this significant number of missed DVTs, the authors recommend the addition of the femoral and deep femoral veins to the two-point compression exam.

Deep Venous Thrombosis: Commonly Affected Veins in the Lower Limbs

Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT). Materials and Methods: A descriptive retrospective study of 46 already diagnosed cases of lower limb DVT. Results: Out of 46 cases of DVT, 71.74% were females. The majority of patients (93.47%) were affected in unilateral lower limb with significant predominance (65.22%) to affect the left lower limb (p Conclusion: Lower limb deep venous thrombosis affects left lower limb more than right and females more than males. Superficial femoral vein (SFV) and common femoral vein (CFV) are the most common affected veins. Lower limb DVT predominantly present in acute stage with venous distension and absent blood flow.

Preventing Lower Extremity Deep Vein Thrombosis After Hip Fracture Surgery in Elderly Patients by Acupoint Application Combined with Pneumatic Compression Therapy

Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the elderly.Methods:Sixty elderly patients who had undergone hip fracture surgery from February 2021 to February 2022 were selected as the research subjects.The patients were divided into two groups via drawing lots.Both the groups received nursing care,but the patients in the observation group were treated with TCM acupoint application combined with pneumatic compression therapy,whereas the control group received pneumatic compression therapy.The evaluation indicators included the patients’quality of life and complications.Results:The incidence of lower extremity deep vein thrombosis in the observation group was more than twice(0.3%),whereas the incidence of lower extremity complications in the control group was more than 6 times(20%).There was a significant difference between the two groups(p<0.05).Conclusion:Traditional Chinese medicine acupoint application combined with pneumatic compression therapy is beneficial for the prevention of postoperative lower extremity deep vein thrombosis among elderly patients.In addition,the patients’overall quality-of-life scores in both physiological and psychological aspects improved significantly,which carries significant clinical reference value.

Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.

Upper extremity deep vein thrombosis:An intensivist’s perspective

Upper extremity deep vein thrombosis(UEDVT)is less common than lower extremity DVT but is a cause of significant morbidity and mortality in intensive care unit patients.Increasing cancer incidence,prolonged life expectancy and increasing use of intravascular catheters and devices has led to an increased incidence of UEDVT.It is also associated with high rates of complications like pulmonary embolism,post-thrombotic syndrome and recurrent thrombosis.Clinical prediction scores and D-dimer may not be as useful in identifying UEDVT;hence,a high suspicion index is required for diagnosis.Doppler ultrasound is commonly employed for diagnosis,but other tests like computed tomography and magnetic resonance imaging venography may also be required in some patients.Contrast venography is rarely used in patients with clinical and ultrasound findings discrepancies.Anticoagulant therapy alone is sufficient in most patients,and thrombolysis and surgical decompression is seldom indicated.The outcome depends on the cause and underlying comorbidities.

Pitfalls and sources of error of color duplex ultrasonography in detecting deep vein thrombosis of proximal lower extremities

Purpose To analyze the sources of errors and discuss the techniques to eliminate pitfalls in detecting deep vein thrombosis (DVT) of the proximal lower extremities with color duplex ultrasonography (CDUS). Methods Sixty-eight cases with initial and repeat venous CDUS of the proximal lower extremities were retrospectively reviewed. The repeat was done within 24 hours after initial CDUS scanning. Comparing repeated images to initial ones, the pitfalls and sources of error in CDUS of the proximal lower extremities were discussed. Results In total 68 repeat studies, there were 62 results as same as initials and 4 cases of false negative DVT and 2 cases of false positive DVT. Conclusion Venous CDUS in detecting DVT is observer dependent. Some pitfalls and errors can be eliminated and corrected with proper scan techniques. CDUS is the most valuable imaging modality for assessing suspected DVT in the proximal lower extremities.

Analysis of curative effect of Bingxiao powder on lower limb deep vein thrombosis

Objective:To investigate the therapeutic effect of Bingxiao powder on edema caused by deep venous thrombosis in lower limb thrombosis.Methods:Selected in our hospital from September 2017 to April 2019 of 122 patients with lower limb deep vein thrombosis caused by edema.The patients were divided into two groups:Bingxio powder(61 cases)and magnesium sulfate(61 cases),the circumference difference of lower leg and thigh,the integral of edema and pain,the effective rate and the satisfaction rate of curative effect were compared between the two groups of patients with edema caused by thrombosis of lower limb.Results:in the observation group,the peripheral diameter difference of calf(1.08±0.21)cm,the peripheral diameter difference of thigh(1.76±0.28),the edema score(1.09±0.22)and the pain score(1.34±0.25)were all lower than those of the control group(P<0.05).The effective rate(95.08%)and satisfaction rate(96.72%)of the observation group were higher than those of the control group(P<0.05).Conclusion:Bingxiao powder can reduce the edema symptoms and pain symptoms of patients with edema caused by deep venous thrombosis of lower limbs,and reduce the circumference difference of the lower leg and thigh,with significant clinical effect.

柚皮素抑制cGAS-STING通路活化对大鼠下肢深静脉血栓形成的影响

【目的】探讨柚皮素抗大鼠下肢深静脉血栓形成机制。【方法】将60只大鼠随机分为6组,即假手术组,模型组,柚皮素低、中、高剂量组和柚皮素高剂量+STING激动剂2.5己酮可可碱(DMXAA)组,每组10只。检测各组大鼠凝血指标[D-二聚体(D-dimer)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)],炎症指标[白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]及氧化应激指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)];苏木素-伊红(HE)染色法检测静脉血栓形成;检测血栓湿质量和干质量;透射电镜检测静脉血栓超微结构;Western Blot法检测静脉血栓组织中环鸟苷酸-腺苷酸合成酶(c GAS)、干扰素基因刺激因子(STING)蛋白表达。【结果】(1)与假手术组比较,模型组大鼠D-dimer水平,IL-1β、IL-6、TNF-α水平,MDA含量,血栓湿质量和干质量增加,TT、APTT、PT,SOD活性和GSH-Px活性降低(均P<0.05);与模型组比较,柚皮素低、中、高剂量组大鼠D-dimer水平,IL-1β、IL-6、TNF-α水平,MDA含量,血栓湿质量和干质量降低,TT、APTT、PT,SOD活性和GSH-Px活性增加(均P<0.05),且呈剂量依赖性;与柚皮素高剂量组比较,柚皮素高剂量+DMXAA组大鼠D-dimer水平,IL-1β、IL-6、TNF-α水平,MDA含量,血栓湿质量和干质量升高,TT、APTT、PT,SOD活性和GSH-Px活性降低(均P<0.05)。(2)与假手术组比较,模型组大鼠静脉血栓组织中cGAS、STING蛋白表达水平升高(P<0.05);与模型组比较,柚皮素低、中、高剂量组大鼠静脉血栓组织中cGAS、STING蛋白表达水平均显著降低(P<0.05);柚皮素高剂量+DMXAA组大鼠cGAS、STING蛋白表达水平显著高于柚皮素高剂量组(P<0.05)。【结论】柚皮素可通过抑制cGAS/STING信号通路活化,抑制炎症、氧化应激反应,从而缓解下肢深静脉血栓形成。

纤维蛋白原/白蛋白比值、Caprini评分、D-二聚体对急性脑梗死后下肢深静脉血栓形成的预测价值

目的 探讨纤维蛋白原/白蛋白比值(FAR)、Caprini评分、D-二聚体(D-D)对急性脑梗死后下肢深静脉血栓(LDVT)形成的预测价值。方法 选取2019年7月至2023年3月在安徽省芜湖市中医医院神经内科住院的急性脑梗死患者122例,根据住院期间双下肢静脉彩超结果将其分为血栓组(42例)和无血栓组(80例),收集两组的基本资料,比较两组FAR、Caprini评分、D-D等指标的差异。建立logistic回归模型分析急性脑梗死后LDVT形成的影响因素,绘制受试者操作曲线比较FAR、Caprini评分、D-D单独及联合对急性脑梗死后LDVT形成的预测价值。结果 血栓组糖尿病患者占比、美国国立卫生研究院卒中量表评分>14分患者占比、格拉斯哥昏迷量表评分>8分患者占比、使用脱水药物>5 d患者占比、Caprini评分及D-D、FAR水平均高于无血栓组,差异有统计学意义(P<0.05)。多因素分析结果显示,Caprini评分(OR=1.803,95%CI:1.173~2.769)、D-D(OR=1.589,95%CI:1.235~2.043)、FAR(OR=1.609,95%CI:1.075~2.408)为急性脑梗死后LDVT形成的独立影响因素(P<0.05)。Caprini评分、FAR、D-D三者联合预测急性脑梗死后LDVT形成的受试者操作曲线下面积高于三者单独预测(P<0.05)。结论 FAR、Caprini评分、D-D与急性脑梗死后LDVT形成有关,可作为LDVT的预测指标,三者联合检测能提高预测效能。

Caprini评分联合纤维蛋白原水平对下肢骨折患者下肢深静脉血栓的预测价值

目的:探究Caprini评分联合纤维蛋白原(fibrinogen,FIB)水平对下肢骨折患者下肢深静脉血栓(deep vein thrombosis,DVT)的预测价值。方法:以2020年1月1日—2022年9月30日中国人民解放军联勤保障部队第904医院收治的下肢骨折患者作为研究对象,共100例。根据术前下肢深静脉彩色多普勒超声检查结果将研究对象分成DVT组(n=11)和非DVT组(n=89)。比较DVT组和非DVT组FIB水平和Caprini评分;基于模型公式:Y=β_(0)+β_(1)×A+β_(2)×B,构建Caprini评分、FIB回归模型;建立受试者操作特征(ROC)曲线,分析Caprini评分、FIB、Caprini评分联合FIB在下肢骨折患者下肢DVT预测中的应用价值。结果:DVT组的Caprini评分、FIB水平均高于非DVT组(P<0.05)。Caprini评分、FIB的二元logistic回归模型为:Y=-21.556+2.637×FIB+1.997×Caprini评分。经ROC曲线分析,FIB预测下肢DVT的曲线下面积(AUC)为0.908,敏感度为81.82%,特异度为92.13%;Caprini评分预测下肢DVT的AUC为0.939,敏感度为90.91%,特异度为85.39%;Caprini评分联合FIB预测下肢DVT的AUC为0.972,敏感度为100%,特异度为86.52%。结论:发生下肢DVT的下肢骨折患者术前的Caprini评分较高,FIB水平呈现异常增高的情况,Caprini评分联合FIB预测下肢DVT的价值更高。

基于Caprini风险评估模型的分级干预联合鼻饲温开水预防危重症患者下肢深静脉血栓的效果

目的:分析基于Caprini风险评估模型的分级干预联合鼻饲温开水对危重症患者下肢深静脉血栓的预防价值。方法:根据随机数字表法将120例于2020年6月—2023年6月在山东大学齐鲁医院接受治疗的危重症患者分为两组。对照组(n=60)接受常规干预,观察组(n=60)接受基于Caprini风险评估模型的分级干预联合鼻饲温开水干预。对两组血液流变学、凝血指标、下肢深静脉血栓风险分级及下肢深静脉血栓发生率进行比较。结果:干预第7天,两组全血高切黏度、全血低切黏度、血小板聚集率和D-二聚体、凝血酶-抗凝血酶复合物均低于干预前,且观察组均低于对照组,两组凝血酶原时间均长于干预前,且观察组长于对照组,差异均有统计学意义(P<0.05);干预第7天,观察组下肢深静脉血栓风险分级优于对照组,下肢深静脉血栓发生率低于对照组,差异均有统计学意义(P<0.05)。结论:基于Caprini风险评估模型的分级干预与鼻饲温开水联合应用,可改善危重症患者的血液流变学和凝血功能,有效预防下肢深静脉血栓发生。