在初级全膝关节整形术后,使用手术前的卡普里尼分数和D-二次数水平确定深静脉血栓形成的高风险群体
Liang Qiao1,2,3,4, Yao Yao1,3,4, Xiaokang You1,3,4
1Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, PR China.
Journal of orthopaedic surgery and research
|October 1, 2024
概括
手术前的卡普里尼评分和D-二次数水平预测了膝盖全关节整形术 (TKA) 后深静脉血栓形成 (DVT) 的风险. 高分数和水平识别了需要有针对性的DVT预防策略的患者.
科学领域:
- 整形外科手术 整形外科手术
- 血管医学 血管医学
- 诊断生物标志物 诊断生物标志物
背景情况:
- 深静脉血栓塞 (DVT) 是膝盖全关节整形术 (TKA) 后的一个风险.
- 卡普里尼评分和D-二次数是已确定的DVT标记物,但在术后不那么可靠.
- 对这些标志物进行与TKA相关的DVT风险的术前评估尚未研究.
研究的目的:
- 评估手术前卡普里尼评分和D-二次数水平对DVT在初级TKA后的预测价值.
- 确定针对性DVT预防的高风险患者群体.
主要方法:
- 对2873名初级TKA患者 (2015年8月至2022年12月) 的回顾性分析.
- 在手术前评估卡普里尼分数和D-二次体水平.
- 手术前的下肢血管多普勒超声波,以排除现有的DVT.
- 手术后的DVT检查. 手术后的DVT检查.
主要成果:
- 手术后的DVT发生在10.55%的患者中.
- 在手术前卡普里尼分数较高的情况下,DVT发生率显著增加 (6.50%为1-2,10.28%为3,18.05%为≥4).
- 随着D-二次体水平升高,DVT的发生率更高 (<0.5 mg/L的8.98%,0.5-1 mg/L的10.61%,≥1 mg/L的14.80%).
- 卡普里尼评分≥4和D-二次数≥1mg/L的患者的DVT率为24.81% (或4.744).
结论:
- 手术前的卡普里尼评分和D-二次数水平是TKA患者手术后DVT风险的显著预测指标.
- 高卡普里尼评分 (≥4) 和高D二次数 (≥1 mg/L) 的结合确定了DVT的高危人群.
- 这些发现支持手术前风险分层和有针对性的干预措施,以减少TKA后的DVT发病率.
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