| 基于Caprini风险评估模型的干预策略对全膝关节置换术后静脉血栓栓塞症的预防效果观察 |
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投稿时间：2022-08-30
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| 作者 | Author | 单位 | Address | E-Mail |
| 赵琦 |
ZHAO Qi |
浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou 311200, Zhejiang, China |
zhaoqizhongy@163.com |
| 吕晓琴 |
LYU XIAO-qin |
浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou 311200, Zhejiang, China |
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| 孙利红 |
SUN Li-hong |
浙江中医药大学附属江南医院 萧山区中医院, 浙江 杭州 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou 311200, Zhejiang, China |
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| 庄伟 |
and 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 311200 |
Jiangnan Hospital Affiliated to Zhejiang Chinese Medicine University Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou 311200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第12期，第1159-1165页 |
| DOI：10.12200/j.issn.1003-0034.2022.12.010 |
| 基金项目: |
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中文摘要:
目的：探讨基于Caprini血栓风险评估模型的干预策略对全膝关节置换术（total knee replacement，TKA）后静脉血栓栓塞症（venous thromboembolism，VTE）的预防效果。
方法：自2017年5月至2021年12月收治257例TKA患者，以2019年5月是否引进Caprini血栓风险评估模型为界分为传统常规干预策略（对照组121例）和基于Caprini血栓风险评估模型的干预策略（观察组136例）。对照组男79例，女42例；年龄50~78（63.10±11.86）岁；体质量指数（body mass index，BMI）19~32（25.21±4.95） kg/m2；左侧55例，右侧66例。观察组男81例，女55例；年龄50~78（64.35±10.54）岁；BMI 19~32（24.43±5.18） kg/m2；左侧87例，右侧49例。比较两组患者术后VTE发生率，疼痛视觉模拟评分（visual analogue scale，VAS），美国特种外科医院（Hospital for Special Surgery，HSS）膝关节评分，患肢肿胀情况，血流平均速度（mean velocity，Vm），峰值速度（peak velocity，PV），D-二聚体（D-dimer，D-D）及凝血酶原时间（prothrombin time，PT）和并发症发生率。
结果：观察组VTE发生率为1.47%（2/136），对照组VTE发生率为9.09%（11/121），两组比较差异有统计意义（χ2=6.976，P=0.008）。术后7 d，观察组VAS、HSS评分及患肢周径差值均明显优于对照组（P<0.05）。术后7 d，两组血流Vm和PV水平均明显升高（P<0.001），且观察组血流Vm、PV水平高于对照组（P<0.001）。术后7 d，观察组血清D-D水平明显低于对照组，PT水平明显高于对照组（P<0.05）。两组并发症发生率比较，差异有统计意义（χ2=4.488，P=0.034）。
结论：基于Caprini血栓风险评估模型的干预策略可有效降低TKA患者VTE发生率及并发症发生率，改善患肢肿胀、血流动力学及凝血功能状态，有助于膝关节功能恢复。 |
| 【关键词】关节成形术,置换,膝 静脉血栓栓塞 风险评估 |
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| Observation of preventive effect of intervention strategy based on Caprini risk evaluation model on venous thromboembolism after total knee arthroplasty |
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ABSTRACT
Objective: To observe preventive effect of Caprini based thrombosis risk evaluation model on venous thromboembolism (VTE) after total knee replacement (TKA).
Methods: Totally 257 TKA patients were admitted from May 2017 to December 2021 were selected. They were divided into conventional intervention strategies (121 patients in control group) and intervention strategies based on Caprini thrombosis risk evaluation model (136 patients in observation group), based on whether Caprini thrombosis risk evaluation model was introduced in May 2019. In normal gourp, there were 79 males and 42 females aged from 50 to 78 years old with an average of (63.10±11.86) years old;body mass index (BMI) ranged from 19 to 32 with an average of (25.21±4.95) kg/m2;55 patients on the left side and 66 on the right side. In observation group, there were 81 males and 55 females aged from 50 to 78 years old with an average of (64.35±10.54) years old;BMI ranged from 19 to 32 with an average of (24.43±5.18) kg/m2;87 patients on the left side and 49 on the right side. The incidence of VTE, visual analogue scale (VAS), Hospital for Special Surgery (HSS) score, affected limb swelling, mean velocity(Vm), peak velocity (PV), D-dimer (D-D), prothrombin time(PT), and incidence of complications were analyzed and compared.
Results: The incidence of VTE in observation group was 1.47%(2/136), and 9.09%(11/121) in control group, and there was statistically difference between two groups (χ2=6.976, P=0.008). At 7 days after operation, VAS, HSS score and the difference in circumference of the affected limb in observation group were significantly better than those in control group, and had statistically differences (P<0.05). Blood flow Vm and PV levels between two groups were significantly increased (P<0.001), and blood flow Vm and PV levels in observation group were significantly higher than those in control group on the 7th day after operation, and had differences (P<0.001). The serum D-D level in observation group was significantly lower than that of in control group on the 7th day after operation, and PT level was significantly higher than that of in control group, and had difference(P<0.05). There was no difference in total incidence of complications between two groups (χ2=4.488, P=0.034).
Conclusion: Intervention strategy based on caprini thrombus risk evluation model could effectively reduce incidence of VTE and complications in TKA patients, improve swelling, hemodynamics and coagulation function of the affected limbs, and contribute to recovery of knee joint function. |
| KEY WORDS Arthroplasty,replacement,knee Venous thromboembolism Risk evaluation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 赵琦,吕晓琴,孙利红,庄伟.基于Caprini风险评估模型的干预策略对全膝关节置换术后静脉血栓栓塞症的预防效果观察[J].中国骨伤,2022,35(12):1159~1165 |
| 英文格式: | ZHAO Qi,LYU XIAO-qin,SUN Li-hong,and ZHUANG Wei.Observation of preventive effect of intervention strategy based on Caprini risk evaluation model on venous thromboembolism after total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(12):1159~1165 |
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