VTE住院患者相关评估量表单纯量表版本讲解课件.ppt

high risk for major bleeding complications * * * PESI=Pulmonary embolism severity index * PESI=Pulmonary embolism severity index * * 肺栓塞严重指数（PESI）已经广泛验证 2014年ESC急性肺栓塞诊断和治疗指南对PESI的评价 PSEI是最广泛验证的评分。 该PESI的主要优势在于可靠识别低风险患者的30天死亡率（PESI?I和II级）。 19. European Heart Journal 2014; 10: 1-48. 总结 用于住院患者的VTE相关量表可以帮助临床医生： 评估VTE风险，从而有效预防VTE的发生（ Caprini、Padua） 诊断VTE （Wells 、RAPT） 及时排除疑似VTE的患者，避免不必要的超声或CT检查 指导诊断流程 评估PE预后（PESI） * 怀疑已存在DVT/PE的患者入科24小时内完成首次DVT-Wells/PE-Wells评分的比率 * * Caprini JA, Arcelus JI, Reyna JJ. Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease. Semin Hematol. 2001,38:12-9. Arcelus JI, Candocia S, Traverso CI, Fabrega F, Caprini JA, Hasty JH. Venous thromboembolism prophylaxis and risk assessment in medical patients. Semin Thromb Hemost. 1991,17 Suppl 3:313-8. Zakai NA, Wright J, Cushman M. Risk factors for venous thrombosis in medical inpatients: validation of a thrombosis risk score. J Thromb Haemost. 2004,2:2156-61. . Pannucci CJ, Bailey SH, Dreszer G, Wachtman CF, Zumsteg JW, Jaber RM, et al. Validation of the Caprini Risk Assessment Model in Plastic and Reconstructive Surgery Patients. J Am Coll Surgeons. 2011,212:105-12. 5. Seruya M, Venturi ML, Iorio ML, Davison SP. Efficacy and safety of venous thromboembolism prophylaxis in highest risk plastic surgery patients. Plast Reconstr Surg. 2008,122:1701-8. 6. ? Bahl V, Hu HM, Henke PK, Wakefield TW, Campbell DA, Jr., Caprini JA. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg. 2010,251:344-50 * 密西根大学健康系統采用Caprini评分作为内科及手术患者的VTE风险评估模型 为验证该评估量表的有效性，国外在西方人群中进行了许多大样本的回顾性验证研究，证实了该量表的有效性和可行性。验证研究的目标人群既有内科住院患者[14-16]，也有手术患者[13, 17-19]，其中最多的是针对外科手术病人的研究。 Caprini JA, Arcelus JI, Reyna JJ. Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease. Semin Hematol. 2001,38:12-9. Arcelus JI, Candocia S, Traverso CI, Fabrega F, Caprini JA, Hasty JH. Venous thromboembolism prop