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术后深静脉血栓形成的术前预测

Preoperative prediction of postoperative deep vein thrombosis.

作者信息

Clayton J K, Anderson J A, McNicol G P

出版信息

Br Med J. 1976 Oct 16;2(6041):910-2. doi: 10.1136/bmj.2.6041.910.

Abstract

A range of clinical data was obtained from 124 patients about to undergo operation and several coagulation tests were performed. No patient received prophylaxis for deep vein thrombosis, and isotopic scanning after operation showed that 20 patients had developed thrombosis. a simiple prognostic index for predicting which patients would develop postoperative deep vein thrombosis was constructed using the clinical and coagulation data obtained before operation. The five variables with the best predictive power-euglobulin lysis time, age, presence of varicose veins, fibrin related antigen, and percentage overweight-produced an equation that identfied 95% of those who developed deep vein thrombosis and misallocated only 28% of those who did not develop thrombosis. In view of the complications that low-dose heparin and dextran can cause, giving prophylaxis to under a third of the patients who will not develop deep vein thrombosis is clearly better than giving it to all.

摘要

从124例即将接受手术的患者身上获取了一系列临床数据,并进行了多项凝血测试。没有患者接受深静脉血栓形成的预防措施,术后同位素扫描显示20例患者发生了血栓形成。利用术前获得的临床和凝血数据构建了一个简单的预测指标,以预测哪些患者会发生术后深静脉血栓形成。具有最佳预测能力的五个变量——优球蛋白溶解时间、年龄、静脉曲张的存在、纤维蛋白相关抗原和超重百分比——得出了一个方程式,该方程式识别出了95%发生深静脉血栓形成的患者,并且仅将28%未发生血栓形成的患者错误分类。鉴于低剂量肝素和右旋糖酐可能引起的并发症,对不到三分之一不会发生深静脉血栓形成的患者进行预防显然比对所有患者进行预防要好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e13/1688494/421de8c8aa40/brmedj00539-0020-a.jpg

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