摘要
目的探讨全膝关节置换术(TKA)术后并发静脉血栓栓塞症(VTE)的危险因素,建立TKA术后VTE快速评估简表,并验证其预测效果。方法采用回顾性病例对照研究,收集2018年1月至2020年1月于台州医院骨科接受TKA的133例并发VTE患者和266例未并发VTE患者的相关资料,对资料进行单因素和多因素分析,确定影响TKA术后VTE的危险因素,构建TKA术后VTE快速评估简表,并检验其区分度和预测效果。结果多因素Logistic回归分析发现,年龄、术前三酰甘油水平、术中使用止血带、高血压、糖尿病、下肢静脉曲张及既往血栓史是影响TKA术后并发VTE的影响因素(P<0.05)。TKA术后VTE快速评估简表能有效区分高危组与低危组,具有良好的区分度。结论年龄、术前三酰甘油水平、术中使用止血带、高血压、糖尿病、有既往血栓史和下肢静脉曲张是TKA术后并发VTE的独立危险因素。通过影响因素的分析与评定,并结合相关指南及文献制定的TKA术后VTE快速评估简表的风险预测效果较好。
Objective The risk factors of venous thromboembolism(VTE)after total knee arthroplasty(TKA)were investigated,and a brief table for rapid assessment of VTE after TKA was established to verify its predictive effect.Methods A retrospective casecontrol study was conducted to collect relevant data on 133 patients with concurrent VTE and 266 patients without concurrent VTE who underwent TKA surgery in the orthopedic department of Taizhou Hospital from January 2018 to January 2020.The data were analyzed univariate and multivariate to determine the risk factors affecting postoperative VTE.A rapid assessment table for postoperative VTE was constructed,and its discrimination and predictive effect were tested.Results Multivariate Logistic regression analysis showed that age,preoperative triacylglycerol levels,use of tourniquet during operation,hypertension,diabetes,varicose veins of lower limbs and previous thrombosis history were influence factors for VTE after TKA(P<0.05).According to the TKA postoperative VTE rapid assessment checklist,patients were divided into high-risk and low-risk groups,with statistically significant differences(P<0.05).The area under the ROC curve was 0.733,the sensitivity was 0.625,and the specificity was 0.701.Conclusions Age,preoperative triacylglycerol level,intraoperative use of tourniquet,hypertension,diabetes,previous history of thrombosis,and varicose veins of lower limbs are independent risk factors for VTE after TKA.By analyzing and evaluating the influencing factors,it is beneficial to reduce the false negative and false positive rates of the simplified form,improve the discrimination of the VTE rapid assessment simplified form after TKA surgery,and thus better predict the risk of VTE complications after TKA surgery.
作者
胡琦
张庆国
叶嘉靖
Hu Qi;Zhang Qingguo;Ye Jiajing(Taizhou Hospital in Zhejiang Province,Taizhou Zhejiang 317000,China)
出处
《医疗装备》
2023年第10期1-5,10,共6页
Medical Equipment
基金
浙江省医药卫生科技计划项目(2020KY1033)。
