摘要
目的 观察血栓风险因素评估表（Caprini模型）对重症加强治疗病房（ICU）患者静脉血栓栓塞症（VTE）的预防效果.方法 选择2014年3月1日至2016年2月29日浙江中医药大学附属第一医院ICU实施Caprini模型后收治的590例患者作为观察组;选择2012年3月1日至2014年2月28日收治的556例ICU患者作为对照组.入院后首日即用Caprini模型进行评分,观察组根据风险等级选择机械预防和低分子肝素钙（速碧林）预防;对照组行常规机械预防,骨科大手术后及严重脓毒症患者使用低分子肝素钙预防.观察两组患者住院期间低分子肝素钙使用率、VTE发生率、低分子肝素使用相关并发症（大出血、肝素诱导的血小板减少症）发生率.结果 观察组低分子肝素钙使用率明显高于对照组[69.83％（412/590）比17.98％（100/556）,P＜0.01];VTE发生率较对照组明显降低[1.02％ （6/590）比2.70％ （15/556）,P＜0.05];观察组和对照组患者低分子肝素钙抗凝治疗期间均未发生大出血,观察组和对照组低分子肝素钙抗凝治疗期间血小板减少症发生率比较差异亦无统计学意义[0.51％ （3/590）比0.18％ （1/556）,P＞0.05].结论 Capfini模型对ICU患者VTE的预防有较好的效果,且不增加大出血等并发症的发生率.
Objective To observe the effect of thrombosis risk factor assessment （Caprini model） on the prevention of venous thrombeembolism （VTE） in patients treated in intensive care unit （ICU）. Methods After using the Caprini risk assessment model in the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, 590 patients treated in ICU from March 1, 2014 to February 29, 2016 were selected as the observation group, and 556 patients in ICU from March 1, 2012 to February 28, 2014 were selected as the control group. The observation group was evaluated by Caprini risk assessment model on the first day of admission, and according to the level of risk, mechanical prophylactic measures or low molecular weight heparin calcium （fraxiparine） was chosen for prevention. The control group underwent mechanical prophylactic measures, while the patients after orthopedic surgery and severe sepsis used low molecular heparin calcium for prevention. The usage rate of low molecular weight heparin calcium, the incidences of VTE and of complications related to using low molecular weight heparin （large amount of bleeding and heparin- induced thrombocytopenia） in the two groups were observed during hospitalization. Results The usage rate of low molecular weight heparin calcium in observation group was significantly higher than that in control group [69.83% （412/590） vs. 17.98% （100/556）, P 〈 0.01]. The incidence of VTE in observation group was obviously lower than that in control group [1.02% （6/590） vs. 2.70% （15/556）, P 〈 0.05]. No large amount of bleeding occurred in patients using low molecular weight heparin calcium to antagonize blood coagulation in observation group and control group. The difference in incidences of heparin-induced thrombecytopenia occurring during application of low molecular weight heparin calcium to antagonize blood coagulation between observation and control groups was not statistically significant [0.51% （3/590） vs. 0.18% （1/556）, P 〉 0.05]. Conclusions The Caprini risk assessment model has a relatively good effect on the prevention of VTE in ICU patients, and does not increase the incidence of complications such as large amount of bleeding, etc.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2016年第6期605-608,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
浙江省自然科学基金（LY17H290006,LY12H29005）
浙江省医药卫生平台计划重点资助项目（2015ZDA022）
浙江省卫生高层次创新人才培养工程资助项目（2014-108）
关键词
血栓风险因素评估表
血栓
肺栓塞
低分子肝素
Thrombosis risk factor assessment
Thrombosis
Pulmonary embolism
Low molecular weight heparin
