Caprini评分联合D-二聚体诊断妇科恶性肿瘤深静脉血栓形成的价值

摘要
图/表
参考文献(22)
相关文章 (15)

全文: PDF (506 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨Caprini评分联合D-二聚体诊断妇科恶性肿瘤患者深静脉血栓形成（DVT）的价值。方法回顾性分析2017年1月~2019年1月山东第一医科大学第一附属医院收治的95例妇科恶性肿瘤术后并发DVT的患者和95例同时期入院未并发DVT的患者的临床资料。分析两组患者的一般资料，比较两组Caprini评分、D-二聚体值及二者联合诊断妇科恶性肿瘤DVT的价值。结果 DVT组患者Caprini评分、D-二聚体显著高于对照组，差异有统计学意义（P < 0.01）；Caprini评分、D-二聚体及二者联合诊断妇科恶性肿瘤患者DVT的ROC曲线下面积分别为0.817、0.860、0.884，灵敏度分别为67.4%、90.5%、61.1%，特异度分别为87.4%、69.5%、95.8%，假阴性率分别为32.6%、9.5%、39.0%，假阳性率分别为12.6%、30.5%、4.2%，阳性预测值分别为85.3%、74.8%、93.6%，阴性预测值分别为72.8%、88.0%、71.1%，阳性似然比分别为5.35、2.97、14.50，阴性似然比分别为0.37、2.97、0.42；Caprini评分联合D-二聚体诊断妇科恶性肿瘤术后DVT患者的似然比与单独使用Caprini评分比较，差异有高度统计学意义（P < 0.01），与单独使用D-二聚体比较，差异无统计学意义（P > 0.05）。结论 Caprini评分联合D-二聚体是一种经济、安全的早期筛查手段，具有一定的临床实用价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	代玲玉1 赵红乐2 赵广芳1 吕梦2 史颜梅2 张淑香2

关键词 ： Caprini评分, D-二聚体, 深静脉血栓, 诊断

Abstract：Objective To investigate the value of Caprini score combined with D-dimer in the diagnosis of deep venous thrombosis (DVT) in patients with gynecologic malignancies. Methods A retrospective analysis of 95 patients with DVT after gynecologic malignancies and 95 patients with concurrent DVT who were admitted to the First Affiliated Hospital of Shandong First Medical University from January 2017 to January 2019. The general data of the two groups were retrospectively analyzed. The values of Caprini score, D-dimer value and the combined diagnosis of DVT in gynecologic malignant tumor were compared. Results The Caprini score and D-dimer in the DVT group were significantly higher than those in the control group (P < 0.01). The ROC curve of DVT in patients with gynecologic malignant tumors was diagnosed by Caprini score, D-dimer and the combination of the two. The lower areas were 0.817, 0.860 and 0.884, respectively. The sensitivity was 67.4%, 90.5% and 61.1%, respectively. The specificities were 87.4%, 69.5% and 95.8%, respectively. The false negative rates were 32.6%, 9.5% and 39.0%, respectively. The positive rates were 12.6%, 30.5% and 4.2%, respectively. The positive predictive values were 85.3%, 74.8% and 93.6%, respectively. The negative predictive values were 72.8%, 88.0% and 71.1%, respectively. The positive likelihood ratios were 5.35, 2.97 and 14.50, respectively. The negative likelihood ratios were 0.37, 2.97 and 0.42, respectively. The likelihood ratio of Caprini score combined with D-dimer in the diagnosis of gynecologic malignant tumor after DVT was compared with Caprini score alone the difference was statistically significant (P < 0.01), the difference was not statistically significant compared with D-dimerm alone (P > 0.05). Conclusion Caprini score combined with D-dimer is an economic and safe early screening method with certain clinical value.

Key words： Caprini score D-dimer Deep vein thrombosis Diagnosis

基金资助:山东省重点研发计划项目（软科学部分）（2017 RKB14047）。

通讯作者: 张淑香（1966-）,女，硕士，主任护师；研究方向：血栓，肠内营养。

作者简介: 代玲玉(1992-)，女，潍坊医学院2017级临床护理专业在读硕士研究生；研究方向：血栓的预防与护理。

引用本文:

代玲玉1 赵红乐2 赵广芳1 吕梦2 史颜梅2 张淑香2. Caprini评分联合D-二聚体诊断妇科恶性肿瘤深静脉血栓形成的价值[J]. 中国医药导报, 2020, 17(2): 85-88.
DAI Lingyu1 ZHAO Hongle2 ZHAO Guangfang1 LYU Meng2 SHI Yanmei2 ZHANG Shuxiang2. The value of Caprini score combined with D-dimer in the diagnosis of deep venous thrombosis in gynecological malignant tumors. 中国医药导报, 2020, 17(2): 85-88.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I2/85

[1] 徐姝娟.深静脉血栓风险评估与预防护理研究进展[J].护理学杂志，2017，32（7）：110-112．
[2] 娄英华，沈怡.Caprini血栓风险评估模型预测妇科恶性肿瘤手术患者DVT风险的有效性研究[J].东南大学学报，2017，36（3）：333-337.
[3] 黄静，阳志军，张洁清，等.妇科恶性肿瘤并发深静脉血栓形成的危险因素及预后影响因素分析[J].中华妇产科杂志，2015，50（10）：762-769.
[4] Paolo Prandoni，Andrea Piccioli，Antonio Girolami. Cancer and venous thromboembolism：an overview [J]. Haematologica，1999，84：437-445.
[5] Davis JD. Prevention，diagnosis，and treatment of venous thromboembolic complications of gynecologic surgery [J]. Am J Obstet Gynecol，2001，184（4）：759-775.
[6] 徐亮，刘凤英，丁倩.Caprini评分、D-二聚体、纤维蛋白原水平在骨折后下肢深静脉血栓病人中的变化及其临床意义[J].临床外科杂志，2019，27（4）：328-330.
[7] 黄蓉，顾建平，楼文胜，等.影像学评估下肢深静脉血栓形成的研究进展[J].介入放射学杂志，2013，22（3）：254-258.
[8] Büller HR，Agnelli G，Hull RD，et al. Antithrombotic Therapy for Venous Thromboembolic Disease：The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy [J]. Chest，2004，126（3）：401.
[9] 门剑龙，翟振国.血栓实验室检查的循证发展与挑战[J].中华检验医学杂志，2017，40（4）：331-334.
[10] 中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南（第２版）[J].中华外科杂志，2012， 50（7）：611-614.
[11] Illinois Medical Society. https：//www.venousdisease.com/caprini-dvt-risk-assessment.pdf.
[12] 方倩.同型半胱氨酸联合D-二聚体检测预警子宫内膜癌术后血栓前状态的临床价值研究[J].黑龙江医药，2018，31（4）：816-818.
[13] Blom JW，Doggen CJ，Osanto S，et al. Malignancies，prothrom-botic mutations，and the risk of venous thrombosis [J]. JAMA，2005，293（6）：715-722.
[14] Caprini JA. Risk assessment as a guide for the prevention of the many faces of venous thromboembolism [J]. Am J Surg，2010，199（Suppl 1）：S3-S10.
[15] Lee YK，Choi YH，Ha YC，et al. Does venous thromboembolism affect rehabilitation after hip fracture surgery [J]. Yonsei Med J，2013，54（4）：1015-1019．
[16] Fisher WD，Agnelli G，George DJ，et al. Extended venous thromboembolism prophylaxis in patients undergoing hip fracture surgery-the SAVE-HIP3 study [J]. Bone Joint J，2013，95（4）：459-466．
[17] van der Velde EF，Toll DB，ten Cate-Hoek AJ，et al. Comparing the diagnostic performance of 2 clinical decision rules to rule out deep vein thrombosis in primary care patients [J]. Ann Fam Med，2011，9（1）：31-36．
[18] 张亚，李琳，孟嘉.骨科大手术术前Autar评分联合D-二聚体值在深静脉血栓形成风险评估中的应用研究[J].护理学报，2018，25（5）：12-14.
[19] 郜茜，王昀.脓毒症休克患者血清C反应蛋白和降钙素原及D-二聚体的变化[J].中国医药，2018，13（7）：1048-1052.
[20] 冼丽娜，杨远征，陈伟，等.降钙素原、超敏C反应蛋白及D-二聚体在脓毒症所致急性呼吸窘迫综合征中的诊断和预后评估价值[J].中国医药导报，2018，15（22）：74-76，84.
[21] 陈方尧.灵敏度与特异度关联条件下Youden指数的样本量估计及meta分析方法[D].广州：南方医科大学，2016.
[22] Goodacre S，Sutton AJ，Sampson F. The value of clinical assessment in the diagnosis of deep vein thrombosis：a meta-analysis [J]. ANN Inter Med，2005，143：129-139．