摘要
目的:探讨脑出血术后患者发生静脉血栓栓塞(VTE)的高危因素并建立预警模式。方法:随机抽取2016年1月至2019年6月温州医科大学附属第一医院神经外科脑出血术后发生VTE的166例患者为观察组,抽取未发生VTE的160例为对照组,收集患者的一般资料、临床资料,分析发生VTE的高危因素。根据VTE发生的高危因素汇总结果及OR值权重建立预警模型。结果:观察组的年龄、体质量、体质量指数(BMI)均高于对照组(P<0.05)。脑出血术后患者VTE发生的高危因素:脱水剂的应用(OR=8.889)、卧床时间≥72 h(OR=7.091)、肢体肌力≤3级(OR=1.515)、中心静脉置管(OR=2.874)、止血药物的应用(OR=2.946)。脑出血术后VTE发生的保护因素:预防性抗凝药的应用(OR=0.444)、浅昏迷和清醒(OR=0.138、0.228)。建立预警模型后,经ROC曲线证实该模型有效,当评分>17.5分时即评价为高风险。结论:通过本研究建立脑出血术后患者VTE发生的风险预警模型可以及时发现高风险患者,尽早采取防治措施。
Objective:To explore the high-risk factors of venous thrombo embolism(VTE)in patients after cerebral hemorrhage and to establish an early warning model to provide reference for the prevention and treatment of VTE.Methods:Totally 166 patients with VTE after neurosurgery cerebral hemorrhage in the First Affiliated Hospital of Wenzhou Medical University from January 2016 to June 2019 were randomly collected as the observation group,and 160 patients without VTE as the control group.Their general information as well as clinical and treatment data were collected,for an analysis of high-risk factors of VTE.An early warning model was established based on the summary results of the high-risk factors of VTE and the weight of the OR value.Results:The age,weight,and body mass index(BMI)of the observation group were higher than those of the control group(P<0.05).High risk factors for VTE in patients after cerebral hemorrhage:application of dehydrating agent(OR=8.889),bed time≥72 h(OR=7.091),muscle strength≤grade 3(OR=1.515),central venous catheterization(OR=2.874),the application of hemostatic drugs(OR=2.946).The protective factors for VTE after cerebral hemorrhage included the application of preventive anticoagulants(OR=0.444).Compared with moderate to severe patients,light coma and conscious patients were not so easily inflicted by VTE(OR=0.138,0.228).After the early warning model was established,the ROC curve proved it was effective.When the score was greater than 17.5 points,it was evaluated as high risk.Conclusion:The establishment of a risk warning model for VTE in patients after cerebral hemorrhage can detect high-risk patients in time so that preventive measures can be taken as soon as possible.
作者
王红霞
张其霞
李冬眉
李菊芳
WANG Hongxia;ZHANG Qixia;LI Dongmei;LI Jufang(Nursing Department of the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Intensive Care Unit of the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Neurosurgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;College of Nursing,Wenzhou Medical University,Wenzhou 325035,China)
出处
《温州医科大学学报》
CAS
2021年第2期128-132,共5页
Journal of Wenzhou Medical University
基金
浙江省卫生健康科技计划面上项目(2021KY792)。
关键词
静脉血栓栓塞
脑出血
手术
高危因素
预警模型
venous thromboembolism
cerebral hemorrhage
surgery
high risk factors
early warning model
