目的:分析Caprini血栓风险评估模型在妇科恶性肿瘤手术患者下肢深静脉血栓形成(DVT)筛选中的有效性。方法:选择妇科恶性肿瘤手术住院患者中确诊为DVT的患者53例作为DVT组,同期入院的106例无DVT的妇科恶性肿瘤手术住院患者作为对照组。采用Caprini血栓风险评估模型对两组患者进行回顾性风险评分、DVT危险度分级。结果:DVT组患者Caprini评分明显高于对照组(7.8±2.6 vs 4.1±2.2,P〈0.001)。DVT组患者中极高危所占比例最高(56.6%),其次为高危(22.6%);对照组高危所占比例最高(30.2%),其次为低危(29.2%),两组构成差异有统计学意义(P〈0.001)。肥胖、肺炎(术后1个月内发生)、下肢水肿(1个月内)、大手术(1个月内)、恶性肿瘤(既往或现患)、DVT/PE疾病史、DVT/PE家族史等7个Caprini风险评估模型中的危险因素是妇科恶性肿瘤患者术后发生DVT的主要危险因素。极高危和高危患者是DVT发病的高危人群(发病风险分别为低危患者的12.743倍和2.132倍)。结论:Caprini血栓风险评估模型可以较好地预测妇科恶性肿瘤手术患者术后DVT的发病风险。
Objective: To analyze the validity of Caprini risk assessment scale in the evaluation of lower extremity deep vein thrombolysis(DVT) risk in gynecologic cancer patients after surgery.Methods: Fifty-three cases of DVT patients admitted were collected as DVT group, and 106 patients without DVT admitted during the same period were selected as control group.Risks in patients of both groups were retrospectively assessed with the Caprini risk assessment model.Results: Caprini score(7.8±2.6) of DVT group was higher than that of the control group(4.1±2.2)(P<0.001);the proportion of highest risk was 56.6% followed by higher risk(22.6%).In the control group, the proportion of the highest risk was 30.2% followed by low risk(29.2%), showing statistically significant difference between the two groups(P<0.001).The results indicated that obesity, pneumonia(<1 month), edema of lower extremity(<1 month), surgery(<1 month) and malignant tumor(past or present), DVT/PE disease history and DVT/PE family history were the major risk factors of the occurrence of DVT in patients with gynecological malignant tumor after operation.The highest and higher risk patients of gynecological malignant tumors evaluated with the Caprini risk assessment model were at higher risk for DVT.Compared with the low-risk patients, the incidence of DVT in the highest and higher risk of gynecologic malignant tumor patients scored by Caprini was respectively 12.743 and 2.132 times higher.Conclusion: Caprini risk assessment model can effectively assess the risk of DVT in gynecologic cancer patients after surgery.