在妇科 laparoscopic 手术后预测下肢深静脉血栓的 nomogram 模型:一个回顾性队列研究
Yuping Zhao1, Renyu Wang1, Shuiling Zu1
1Nursing Department, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China.
PeerJ
|September 26, 2023
概括
一个预测模型有效地识别了在妇科腹腔镜手术后面临下肢深静脉血栓形成风险的患者. 关键的风险因素包括年龄,操作持续时间和特定的生物标志物,如D-二聚合物和HE4.
科学领域:
- 妇科外科手术 妇科外科
- 血管医学 血管医学
- 在瘤学瘤学.
背景情况:
- 下肢深静脉血栓塞 (LEDVT) 是妇科手术中一个重要的术后并发症.
- 识别风险因素和开发预测工具对于预防至关重要.
研究的目的:
- 在接受妇科腹腔镜手术的患者中调查LEDVT的危险因素.
- 为LEDVT风险建立一个预测性名录模型.
主要方法:
- 来自659名接受妇科腹腔镜手术的患者的临床数据的回顾性审查.
- 多变量逻辑回归用于识别独立的风险因素.
- 基于已识别的风险因素,开发一个名ogram.
主要成果:
- 52名患者 (7.89%) 患有术后的LEDVT.
- 确定了独立的风险因素:年龄较大,手术持续时间较长,激活部分血栓形成时间 (APTT) 较短,D-二次数较高,人体流行病蛋白4 (HE4) 较高,有高血压史.
- 诺莫格拉姆模型显示出高预测精度 (AUC 0.927,灵敏度 96.1%,特异性 79.5%).
结论:
- 纳米图包括年龄,手术持续时间,APTT,D-二次数,高血压史和HE4,可以有效预测LEDVT风险.
- 这种模型可以帮助在接受妇科腹腔镜手术的患者中预防LEDVT.
相关概念视频
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
14
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
14
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Venous Thrombosis I: Introduction
12
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
12
Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15


