Lu Xiuying, Zeng Weirong, Zhu Lin, Liu Lu, Du Fengmei, Yang Qing
Department of Operating Room.
Department of Gastrointestinal Surgical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Medicine (Baltimore). 2021 Jan 29;100(4):e24479. doi: 10.1097/MD.0000000000024479.
Application of the Caprini risk assessment model was explored in patients with deep vein thrombosis (DVT) after laparoscopic colorectal cancer surgery.This study was a prospective study. The risk factors for DVT were assessed with a survey at baseline and on the morning of surgery, first day after surgery and sixth day by using repeated blood vessels on color Doppler ultrasound of the lower limbs, and the intraoperative and postoperative conditions were recorded.Among 148 surgical patients, 24.3% had asymptomatic DVT. According to the risk stratification, the incidence of DVT was related to the Caprini score (P < .001). The area under the curve of the Caprini model was 0.701 ± 0.047 (95% CI: 0.609-0.793, P<.001). The Youden index was 0.368, while the critical point was 10.5 in the Caprini model, corresponding to a sensitivity of 0.806 and a specificity of 0.563. Age, cardiovascular disease, intraoperative blood loss, postoperative fever, preoperative preparation, and hospital stay were higher in DVT patients than in patients without DVT. Moreover, the incidence of DVT in patients with a lithotomy position was higher than that in patients with a scissors position. In binary logistic regression analysis, the independent risk factors for DVT development were age, intraoperative blood loss, and preoperative preparation time.The Caprini model can be used for the prediction of venous thromboembolism in laparoscopic colorectal cancer surgery patients. The thrombosis risk assessment model must be established in line with patients undergoing endoscopic malignant tumor surgery.
探讨Caprini风险评估模型在腹腔镜结直肠癌手术后深静脉血栓形成(DVT)患者中的应用。本研究为前瞻性研究。通过在基线、手术当天上午、术后第一天和第六天进行调查,使用下肢彩色多普勒超声重复检查血管来评估DVT的危险因素,并记录术中及术后情况。148例手术患者中,24.3%有无症状DVT。根据风险分层,DVT的发生率与Caprini评分相关(P<0.001)。Caprini模型的曲线下面积为0.701±0.047(95%CI:0.609 - 0.793,P<0.001)。约登指数为0.368,Caprini模型的临界点为10.5,对应灵敏度为0.806,特异度为0.563。DVT患者的年龄、心血管疾病、术中失血、术后发热、术前准备和住院时间均高于无DVT的患者。此外,截石位患者的DVT发生率高于剪刀位患者。在二元逻辑回归分析中,DVT发生的独立危险因素为年龄、术中失血和术前准备时间。Caprini模型可用于预测腹腔镜结直肠癌手术患者的静脉血栓栓塞。必须根据接受内镜恶性肿瘤手术的患者建立血栓形成风险评估模型。