摘要
目的应用Meta分析法综合评价Caprini血栓风险评估量表对外科手术患者静脉血栓栓塞症(VTE)危险预测的有效性。方法检索Cochrance Library、PubMed、Web of Science、EMBASE、中国生物医学文献数据库、CNKI、万方数据库、维普数据库收集关于Caprini血栓风险评估量表预测VTE的研究,检索时限均为数据库建立至2017年12月31日。利用诊断性研究质量评价工具对纳入的文献进行质量评价,并采用Meta-Disc1.4软件和Stata软件进行数据分析。结果最终纳入7篇文献(n=1520)。异质性检验显示,纳入的研究存在异质性,通过随机效应模型计算合并灵敏度为0.85(95%CI:0.79~0.90),合并特异度为0.58(95%CI:0.55~0.61),合并阳性似然比为2.16(95%CI:1.76~2.65),合并阴性似然比为0.18(95%CI:0.07~0.48),合并诊断比值比为12.06(95%CI4.76~30.56),汇总受试者工作特征(SROC)曲线下面积为0.748;无发表偏倚。结论Caprini血栓风险评估量表作为单独指标对外科手术患者VTE预测有效性的预测敏感度高,总体诊断效能较强,能有效筛检出有静脉血栓风险的患者,有一定诊断价值,但特异度较低,建议今后针对量表开展更多前瞻性研究及制定合适的临界值。
Objective To comprehensively review the forecasting effect of Caprini risk assessment model for venous thromboembolism (VTE) on VTE among surgery patients with the method of Meta analysis. Methods We retrieved the articles on the forecasting Caprini risk assessment model for VTE on VTE in the Cochrance Library, PubMed, Web of Science, EMBASE, China Biology Medicine, China National Knowledge Infrastructure (CNKI), WanFang data, Vip Database (VIP) published from establishing database to 31st December 2017. The diagnostic studies quality evaluation instrument was used to assess the quality of the included articles and the data were analyzed with the Meta-Disc 1.4 software and Stata software. Results A total of 7 articles were included (n=1 520). Heterogeneity test showed that there was heterogenicity in the included researches with 0.85 (95% CI: 0.79-0.90) for the combined sensibility by random effect model, 0.58 (95% CI: 0.55-0.61) for the specificity, 2.16 (95% CI: 1.76-2.65) for the positive likelihood ratio, 0.18 (95% CI: 0.07-0.48) for the negative likelihood ratio and 12.06 (95% CI: 4.76-30.56). The area under the curve of summary receive opearating characteristic curve (SROC) was 0.748 with no publication bias. Conclusions The Caprini risk assessment model for VTE is a single indicator for the forecasting effect of the VTE of patients with surgery along with a high predictive sensibility and a strong overall diagnostic efficiency. It can effectively screen patients with the risk of venous thrombosis with a diagnostic value and low specificity. We should carry out many perspective studies and establish a suitable critical value aiming at scales in the future.
作者
王彦艳
王炎
刘延锦
赵辉
徐慧萍
韩娜
Wang Yanyan;Wang Yan;Liu Yanjin;Zhao Hui;Xu Huiping;Han Na(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Blood Purification,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Nursing Department,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Breast,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华现代护理杂志》
2019年第3期313-318,共6页
Chinese Journal of Modern Nursing
基金
中国研究型医院学会护理分会临床护理研究课题(2017-20-3)
河南省卫计委与省学会共建项目(201503H008).
