首页|6种血栓评估量表对胃肠道肿瘤患者深静脉血栓形成的预测价值评估

6种血栓评估量表对胃肠道肿瘤患者深静脉血栓形成的预测价值评估

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目的 比较Autar、Wells、Padua、Caprini、Khorana及COMPASS-CAT这6种评估量表对胃肠道肿瘤患者下肢深静脉血栓形成(deep venous thrombosis,DVT)发生的预测价值.方法 前瞻性地对2023年3月至2023年10月期间在兰州大学第二医院普外三病区接收手术治疗的胃肠道肿瘤患者在术后第3天用Autar、Wells、Padua、Caprini、Khorana及COMPASS-CAT评估量表对胃肠道肿瘤患者发生DVT的风险进行评估,同时进行下肢血管彩色多普勒超声检查,比较其检查结果发生和未发生DVT患者的6种评估量表的评分,同时采用受试者操作特征曲线下面积(area under receiver operating characteristic curve,AUC)评估这6种评估量表区分胃肠道肿瘤患者下肢DVT发生的能力.结果 本研究最终纳入符合标准的胃肠道肿瘤患者108例,其中男71例、女37例;年龄18~85岁、(58.3±11.2)岁.发生DVT42例(38.9%),其中发生DVT患者的年龄大于未发生DVT患者(P<0.05),而未发现二者在体质量指数、性别、肿瘤位置、合并疾病等方面比较差异有统计学意义(P>0.05);发生DVT患者的Autar、Padua及Caprini评估量表评分高于未发生DVT患者(P<0.05),而二者的Wells、Khorana 及 COMPASS-CAT 评估量表评分比较差异无统计学意义(P>0.05).Autar、Wells、Padua、Caprini、Khorana及COMPASS-CAT评估量表区分胃肠道肿瘤患者DVT发生的AUC分别为0.907、0.548、0.636、0.627、0.589、0.535,敏感度分别为 97.6%、14.3%、52.4%、83.3%、47.6%及 21.4%,特异度分别为 2.4%、85.7%、47.6%、16.7%、52.4%及 78.6%.结论 从本研究对 Autar、Wells、Padua、Caprini、Khorana 及 COMPASS-CAT 这 6 种评估量表用于胃肠道肿瘤患者术后区分DVT发生的能力看,仅发现Autar评估量表的区分能力较好,其他5个评估量表的区分能力一般.
Evaluation of predictive value of six thrombosis assessment scales for deep vein thrombosis in patients with gastrointestinal tumors
Objective To compare the predictive value of six thrombotic risk assessment scales,including Autar,Wells,Padua,Caprini,Khorana,and COMPASS-CAT,for the deep venous thrombosis(DVT)of lower extremity in patients with gastrointestinal tumors.Methods The patients with gastrointestinal tumors who received surgical treatment in the General Surgery Department of Lanzhou University Second Hospital from March 2023 to October 2023 were collected.The risk of DVT on day 3 after surgery for the patient with gastrointestinal tumors was prospectively evaluated using the Autar,Wells,Padua,Caprini,Khorana,and COMPASS-CAT assessment scales.And the DVT was detected by ultrasound examination.The pionts of six thrombotic risk assessment scales were compared between the patient with DVT and without DVT based on the ultrasound examination results.The predictive value of the six thrombotic risk assessment scales for the lower extremity DVT in the patients with gastrointestinal tumors was evaluated by the area under receiver operating characteristic curve(AUC).Results A total of 108 patients who met the criteria,including 71 males and 37 females,were enrolled,age ranged from 18 to 85 years old,(58.3±11.2)years old.Fourty-two cases(38.9%)of DVT occurred.The age of patients with DVT was older than that of patients without DVT(P<0.05),but there were no statistical differences in the gender,body mass index,tumor location,comorbidities,and so on(P>0.05).The points of Autar,Padua,and Caprini in the patients with DVT were higher than those in the patients without DVT(P<0.05),while there were no statistical differences in the points of Wells,Khorana,and COMPASS-CAT between the two(P>0.05).The AUC for differentiating the occurrence of DVT in the patients with gastrointestinal tumors using the Autar,Wells,Padua,Caprini,Khorana,and COMPASS-CAT assessment scales were 0.907,0.548,0.636,0.627,0.589,and 0.535,respectively;The sensitivities were 97.6%,14.3%,52.4%,83.3%,47.6%,and 21.4%;The specificities were 2.4%,85.7%,47.6%,16.7%,52.4%,and 78.6%,respectively.Conclusion According to the abilities of Autar,Wells,Padua,Caprini,Khorana,and COMPASS-CAT to distinguish the occurrence of DVT in patients with gastrointestinal tumors after surgery,only the Autar evaluation scale is found to be more effective,while the other five evaluation scales are generally able to distinguish the occurrence of DVT.

deep vein thrombosisgastrointestinal tumorsassessment scalepredictive valuereceiver operating characteristic curve

李伟、张乐、汪文杰、陈晓

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兰州大学第二医院普外科(兰州 730000)

深静脉血栓形成 胃肠道肿瘤 评估量表 预测价值 受试者操作特征曲线

甘肃省青年科技基金

21JR7RA424

2024

中国普外基础与临床杂志
四川大学华西医院

中国普外基础与临床杂志

CSTPCD
影响因子:0.858
ISSN:1007-9424
年,卷(期):2024.31(1)
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