基于Caprini风险评估模型的干预策略及应用于预防全髋关节置换术后深静脉血栓的效果分析
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作者Author单位AddressE-Mail
陈爱红 CHEN Ai-hong 浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 300211 Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine (Xiaoshan Hospital of Traditional Chinese Medicine), Hangzhou 300211, Zhejiang, China caicaiyuyu12@163.com 
钱爱萍 QIAN Ai-ping 浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 300211 Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine (Xiaoshan Hospital of Traditional Chinese Medicine), Hangzhou 300211, Zhejiang, China  
庄伟 ZHUANG Wei 浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 300211 Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine (Xiaoshan Hospital of Traditional Chinese Medicine), Hangzhou 300211, Zhejiang, China  
曹国平 CAO Guo-ping 浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 300211 Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine (Xiaoshan Hospital of Traditional Chinese Medicine), Hangzhou 300211, Zhejiang, China  
高飞 GAO Fei 浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 300211 Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine (Xiaoshan Hospital of Traditional Chinese Medicine), Hangzhou 300211, Zhejiang, China  
陈妙仙 CHEN Miao-xian 浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 300211 Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine (Xiaoshan Hospital of Traditional Chinese Medicine), Hangzhou 300211, Zhejiang, China  
期刊信息:《中国骨伤》2022年,第35卷,第9期,第853-858页
DOI:10.12200/j.issn.1003-0034.2022.09.010
基金项目:浙江省科技卫生计划(编号:2020RC096)
中文摘要:

目的:分析应用Caprini血栓风险评估模型的干预策略对预防全髋关节置换术(total hip replacement,THR)后深静脉血栓(deep vein thrombosis,DVT)的效果。

方法:选取自2018年1月至2021年12月收治的197例THR患者作为回顾性队列研究对象,男114例,女83例;年龄45~80(66.81±10.34)岁。以2019年5月引进Caprini血栓风险评估模型为界分为两组,94例行传统常规干预策略(对照组),103例行基于Caprini血栓风险评估模型的干预策略(观察组)。统计分析两组DVT发生率,疼痛视觉模拟评分(visual analogue scale,VAS),患肢周径差值,血清D-二聚体(D-D)水平及髋关节功能Harris评分。

结果:197例获得随访,时间1~3(2.57±0.31)个月。观察组DVT发生率为1.94%(2例),对照组DVT发生率为11.70%(11例),两组比较差异有统计意义(χ2=6.642,P=0.010)。两组患者术后VAS均逐渐降低(P<0.001),两组患者术后1、2、3、7 d VAS评分比较差异有统计意义(P<0.05),但两组术后10 d VAS比较差异无统计意义(P>0.05)。两组术后患肢周径差值均逐渐缩小(P<0.001),两组术后1、2、3、7、10 d患肢周径差值比较差异有统计意义(P<0.05)。两组术后血清D-D水平均逐渐降低(P<0.05),两组术后8、24、48、72 h血清D-D水平相比差异有统计意义(P<0.05)。两组患者术后疼痛评分和Harris总评分均随时间逐渐升高(P<0.001),两组患者术后出院3个月疼痛评分比较差异有统计学意义(P<0.05),两组患者术后出院即刻、出院后1和3个月Harris总评分比较差异有统计学意义(P<0.001)。

结论:基于Caprini血栓风险评估模型的干预策略有助于降低THR患者DVT发生率,改善术后疼痛和患肢肿胀,促进髋关节功能恢复。
【关键词】关节成形术,置换,髋  静脉血栓形成  风险评估与减低
 
Intervention strategy based on Caprini risk assessment model and its clinical effect in preventing deep vein thrombosis after total hip replacement
ABSTRACT  

Objective: To analyze clinical effect of intervention strategies based on Caprini thrombosis risk assessment model for preventing deep vein thrombosis (DVT) after total hip replacement (THR).

Methods: From January 2018 to December 2021,197 patients with THR were selected as retrospective cohort study subjects,including 114 males and 83 females,aged from 45 to 80 years with an average of (66.81±10.34) years old.Caprini thrombosis risk assessment model introduced in May 2019 was used as boundary and divided into two groups,94 patients were performed routine intervention strategies (control group) and 103 patients were received intervention strategies based on Caprini thrombosis risk assessment model (observation group).Incidence of DVT,visual analogue scale (VAS),circumference difference of affected limb,serum D-dimer (D-D) level and Harris score of hip function between two groups were analyzed.

Results: One-hundred and ninty-seven patients were followed up from 1 to 3 months with an average of (2.57±0.31) months.Incidence of DVT was 1.94% in observation group and 11.70% in control group,and there was statistical difference between two groups (χ2=6.642,P=0.010).VAS scores between two groups decreased gradually (P<0.001).There was significant difference between two groups in VAS score on the 1st,2nd,3rd and 7th day after operation (P<0.05),but no difference between two groups on the 10th day after operation (P>0.05).Difference in circumference of the affected limb between two groups after operation was gradually reduced (P<0.001),and the difference in circumference of the affected limb between two groups was statistically significant on the 1st,2nd,3rd,7th,and 10th day after operation (P<0.05).Levels of serum D-D between two groups were gradually decreased after operation (P<0.05),and differences in serum D-D levels between two groups on the 8th,24th,48th,and 72th hour after operation were statistically significant (P<0.05).Pain score and Harris total scores between two groups were significantly increased as tomes goes on (P<0.001),no difference in VAS at 3 months after discharge,and there were statistically significant differences in Harris scores between two groups immediately after discharge,1 month and 3 months after discharge (P<0.001).

Conclusion: Intervention strategy based on Caprini thrombosis risk assessment model could reduce incidence of DVT in patients with THR,improve postoperative pain and swelling of the affected limb,and promote recovery of hip joint function.
KEY WORDS  Arthroplasty,replacement,hip  Venous thrombosis  Risk evaluation and mitigation
 
引用本文,请按以下格式著录参考文献:
中文格式:陈爱红,钱爱萍,庄伟,曹国平,高飞,陈妙仙.基于Caprini风险评估模型的干预策略及应用于预防全髋关节置换术后深静脉血栓的效果分析[J].中国骨伤,2022,35(9):853~858
英文格式:CHEN Ai-hong,QIAN Ai-ping,ZHUANG Wei,CAO Guo-ping,GAO Fei,CHEN Miao-xian.Intervention strategy based on Caprini risk assessment model and its clinical effect in preventing deep vein thrombosis after total hip replacement[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(9):853~858
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