| 摘要: |
| 目的:分析血管外科会诊的围手术期孤立性远端深静脉血栓(IDDVT)加重的危险因素并建立预测模型。方法:回顾性分析2021年1月—12月天津市人民医院血管外科接收的外科组会诊病历资料831份，共纳入563例患者，根据会诊前后围手术期患者血栓范围是否加重分为加重组(61例)及未加重组(502例)，比较两组的临床资料，应用Lasso回归模型和多因素Logistic回归分析血管外科会诊的围手术期IDDVT加重的独立危险因素。用筛选的独立危险因素构建预测模型，绘制列线图。结果:血栓加重组的女性比例、卧床时间＞72 h比例、体质量指数(BMI)、白细胞计数(WBC)及球蛋白(GLO)、血小板(PLT)水平均大于未加重组，年龄、冠心病史及手术史比例、白蛋白(ALB)、血红蛋白(HGB)水平均小于未加重组，差异有统计学意义(P ＜0.05)，而在高血压等一般病史和D二聚体、纤维蛋白原等相关指标方面，两组无明显统计学差异，多因素Logistic回归分析表明，性别为女性、更高的BMI及WBC和GLO、卧床时间＞72 h是血管外科会诊中的围手术期IDDVT加重的独立危险因素(P ＜0.05)，预测模型的ROC曲线下面积为0.848。结论:性别、BMI、WBC、GLO、卧床时间＞72 h与血管外科会诊的围手术期孤立型远端静脉血栓加重具有相关性，此研究构建的预测模型具有准确性，可为围手术期IDDVT患者提供个体化指导方案。 |
| 关键词: 会诊 围手术期 孤立型远端深静脉血栓 危险因素 预测模型 |
| DOI：10.3969/j.issn.1007-6948.2025.05.019 |
| 投稿时间：2025-01-11 |
| 基金项目:天津市人民医院院级课题(2022PWXK07) |
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| Risk factors analysis and prediction model construction of isolated distal deep vein thrombosis exacerbation during perioperative vascular surgery consultation |
| GUO Su-li,FAN Zi-yang,LIU Hong |
| Department of Vascular, Tianjin Union Medical Center, Tianjin300121，China |
| Abstract: |
| Objective To analyze the risk factors for exacerbation of isolated distal deep vein thrombosis (IDDVT) during perioperative consultation in vascular surgery and establish a prediction model. Methods A retrospective analysis was performed on 831 consultation medical records of the surgical group received by the Department of Vascular Surgery of Tianjin Union Medical Center from January 2021 to December 2021.A total of 563 cases were included. According to whether the extent of thrombosis was aggravated before and after the consultation, the patients were divided into aggravated group and non-aggravated group, including 61 cases of aggravated group and 502 cases of non-aggravated group. Lasso regression model and multiple Logistic regression were used to analyze the independent risk factors of IDDVT exacerbation during perioperative period of vascular surgical consultation. A prediction model was constructed with screened independent risk factors and a nomogram was drawn. Results The proportion of women with aggravated group, the proportion of bed time >72 h, BMI, WBC, GLO and PLT levels were higher than non-aggravated group, and the age, the proportion of coronary heart disease history and surgical history, ALB and HGB levels were lower than non-aggravated group, with statistical differences (P <0.05). In terms such as hypertension and D-dimer, FIB, there was no significant difference between the two groups. Multivariate Logistic regression analysis showed that, Gender being female, higher BMI, WBC and GLO, and bed time >72 h were independent risk factors for perioperative IDDVT exacerbation in vascular surgery consultations (P <0.05), and the area under ROC curve of the predictive model was 0.848. Conclusions Gender, BMI, WBC, GLO, and bed time >72 h are associated with perioperative isolated distal venous thrombosis exacerbation in vascular consultation. The prediction model constructed in this study is accurate and can provide individualized guidance for perioperative IDDVT patients in vascular consultation. |
| Key words: Consultation perioperative period isolated distal deep vein thrombosis risk factors prediction model |
