Kamusella P, Wissgott C, Boyé A, Müller S, Richter A, Schink T, Klein-Weigel P, Steinkamp H
Radiologie, Carl Gustav Carus Universitätsklinikum Dresden, Dresden, Germany.
Rofo. 2008 Dec;180(12):1110-6. doi: 10.1055/s-2008-1027849. Epub 2008 Oct 29.
Application and verification of the Wells score for pre-test probability of deep vein thrombosis in the lower limbs in clinical routine. The goal was to reduce the number of immediate diagnostic measures for excluding vein thrombosis during acute investigation. New parameters for upgrading or modification the existing score were checked.
In a period from March through November 2007, 333 patients were assigned to the department of radiology in order to exclude deep vein thrombosis. A standardized questionnaire was used to identify the probability of deep vein thrombosis. The patients were categorized as low, moderate, and high risk. The examination was conducted with colored-coded duplex sonography.
In the patient population of 333, 41 (12 %) had deep vein thrombosis of the lower limb. The prevalence was approximately 3 % in the low risk group, 34 % in the moderate risk group, and 63 % in the high risk group. Categorization with the Wells score is an instrument with high sensitivity (99.6 %) and specificity (100 %).
The pre-test probability with the Wells score represents a useful and established instrument in the clinical routine. Acute examinations, especially during stand-by, can be reduced without neglecting patient safety. Patients with a Wells score of 0 don't require an acute examination. An elective investigation should be targeted. Patients with a score between 1 and 8 needed to be treated (within the next 24 hours) with KS and FKDS. According to on our data records, therapy should be started immediately for patients with a high risk of deep vein thrombosis.
在临床常规中应用和验证Wells评分以评估下肢深静脉血栓形成的预检概率。目标是减少急性检查期间排除静脉血栓形成的即时诊断措施的数量。检查了用于升级或修改现有评分的新参数。
在2007年3月至11月期间，333例患者被送至放射科以排除深静脉血栓形成。使用标准化问卷来确定深静脉血栓形成的可能性。患者被分为低、中、高风险类别。采用彩色编码双功超声进行检查。
在333例患者中，41例（12%）患有下肢深静脉血栓形成。低风险组的患病率约为3%，中风险组为34%，高风险组为63%。使用Wells评分进行分类是一种具有高敏感性（99.6%）和特异性（100%）的工具。
Wells评分的预检概率是临床常规中一种有用且成熟的工具。可以减少急性检查，尤其是在待命期间，而不会忽视患者安全。Wells评分为0的患者不需要进行急性检查。应进行选择性检查。评分为1至8的患者需要（在接下来的24小时内）用KS和FKDS进行治疗。根据我们的数据记录，对于深静脉血栓形成高风险的患者应立即开始治疗。
