Caprini风险评估模型在慢性阻塞性肺疾病中应用分析.doc

Caprini风险评估模型在慢性阻塞性肺疾病中应用分析 　　摘要：目的 探讨Caprini风险评估模型在慢性阻塞性肺疾病急性加重期（AECOPD） 患者静脉血栓栓塞（VTE） 预防中的应用探索。方法 583例AECOPD患者均按照Caprini风险评估模型进行VTE危险度评估，据Caprini风险评估模型将病人分为低危组（≤1分）、中危组（2分）、高危组（3～4分）和极高危组（4分）；对非低危组同意应用低分子肝素钠者进行预防性抗凝治疗。观察各组间VTE发生率、出血发生率。结果 非低危组拒绝应用低分子肝素抗凝病例267例，其VTE的发病率为7.87%（21/267）。抗凝治疗组VTE的整体发生率为0.95%（3/316），其中2例为DVT，1例为非高危PTE；抗凝治疗病例中出血发生率为2.59%（8/309）。结论 临床上，利用Caprini风险评估模型对AECOPD患者进行VTE分层并给予预防性干预，能够评估及降低VTE发生率。但仍需进一步改进以更加符合中国人AECOPD患者VTE风险评估。 　　关键词：慢性阻塞性肺疾病；静脉血栓栓塞症；Caprini风险评估模型 　　中图分类号：R563.9 文献标识码：A 文章编号：1006-1959（2017）26-0044-03 　　Abstract：Objective To explore the application of Caprini risk assessment model in the prevention of venous thromboembolism（VTE）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods A total of 583 AECOPD patients were evaluated for VTE risk according to the Caprini risk assessment model.According to the Caprini risk assessment model，patients were divided into low risk group（≤1 points）， intermediate risk group（2 points），high risk group（3 to 4 points）and very high-risk group （4 points）；The low risk group agreed to the application of low molecular weight heparin for anticoagulation therapy.The incidence rate was observed between VTE and incidence of bleeding.Results A total of 267 cases of low molecular weight heparin anticoagulation were rejected in non-low-risk group.The incidence of VTE was 7.87%（21/267）.The overall incidence of VTE in the anticoagulant group was 0.95%（3/316），of which 2 were DVT and 1 was non-high-risk PTE.The incidence of bleeding in anticoagulation was 2.59%（8/309）.Conclusion Clinically，the use of Caprini risk assessment model of AECOPD patients with VTE stratification and preventive intervention，to assess and reduce the incidence of VTE.However，further improvement is needed to better assess the VTE risk of AECOPD patients in China. 　　Key words：Chronic obstructive pulmonary disease；Venous thromboembolism；Caprini risk assessment model 　　静脉血栓栓塞栓塞症（Venous thromboembolism