肿瘤预防与治疗2019，Vol.32Issue(8)：660-667,8.DOI:10.3969/j.issn.1674-0904.2019.08.002
Caprini和Rogers血栓风险评估模型在胸外科肺癌患者围手术期应用的验证研究✲
Application of Caprini and Rogers Risk Assessment Models in the Periop-erative Management of Lung Cancer Patients
摘要
Abstract
Objective: To analyze the applicability of Caprini and Rogers risk assessment models for venous thromboem-bolism (VTE) in the perioperative management of for lung cancer patients in the Department of Thoracic Surgery, and verify the validity of the two models. Methods: Lung cancer patients undergoing surgery in the Department of Thoracic Surgery in Sichuan Cancer Hospital from March 2015 to March 2017 were enrolled according to the inclusion criteria. No patient re-ceived postoperative prophylactic anticoagulation. All patients underwent vascular ultrasound of the legs in the perioperative period. Patient with suspected pulmonary embolism (PE) underwent computed tomography scan. Clinical and laboratory in-dexes were collected prospectively. Caprini and Rogers risk assessment models were used for all patients to assess the risk of VTE. Incidence and risk factors of VTE were analyzed. Differences in the incidence and risk factors of postoperative VTE and laboratory indexes between the two groups were analyzed. Results: A total of 152 patients were enrolled in this study. The incidence of postoperative deep vein thrombosis (DVT) was 25% (38／152), and no PE occurred. All patients with Ca-prini scores of 8－15 were most commonly at high risk for VTE, including 66 cases in the high-risk group (5－8 points) and 86 cases in the extremely high-risk group (>9 points). Difference in the incidence of DVT between the two groups was not significant (27. 3% vs 23. 3% ,P=0. 46). The Rogers scores ranged from 9 to 18 across all patients including 67 cases in the low-risk group (7－10 points) and 85 cases in the moderate-risk group (>10 points). There was no significant differ-ence in the incidence of DVT between the two groups (25. 4% vs 24. 7% , P=0. 64). Significant differences were found neither in the risk factors of DVT (age, smoking index, blood type, history of chronic obstructive pulmonary disease, histo-logical type, video-assisted thoracoscopic surgery, operation time, postoperative bed rest time and pathologic stage) nor in perioperative D-dimmer levels, fibrinogen levels, fibrinogen degradation products and neutral-lymphocyte ratio between the Caprini high-risk and the Caprini extremely high-risk groups or between the Rogers low-risk group and the Rogers moderately high-risk group. Conclusion: Caprini venous thromboembolism risk assessment model tends to evaluate the lung cancer pa-tients undergoing thoracic surgery as high－risk of VTE. It is highly significant in guiding the prevention of VTE. Caprini and Rogers risk assessment models, however, are inexact in risk stratification of VTE for perioperative lung cancer patients in the Department of Thoracic Surgery. It is necessary to establish a new system of thrombosis risk assessment suitable for Chi-nese lung cancer patients’ characteristics.关键词
肺癌/围术期/VTE/Caprini/RogersKey words
Lung cancer/Perioperative period/Venous thromboembolism/Caprini/Rogers分类
医药卫生引用本文复制引用
郭海,方强,黄建鸣,周红,任光国,韩泳涛..Caprini和Rogers血栓风险评估模型在胸外科肺癌患者围手术期应用的验证研究✲[J].肿瘤预防与治疗,2019,32(8):660-667,8.基金项目
四川省科技厅科研基金(编号:2014JY0251) This study was supported by grants from Science &Technology Department of Sichuan Province ( NO. 2014JY0251) . （编号:2014JY0251）
