2022 年第 3 期 第 17 卷

D-二聚体联合血栓风险评估表对产妇静脉血栓栓塞的诊断价值

The diagnostic value of D-dimer combined with the thrombotic risk assessment table in maternal venous thrombosis

作者：韦海棠李静黄春力马艳华

英文作者：Wei Haitang Li Jing Huang Chunli Ma Yanhua

单位：广西壮族自治区人民医院产科，南宁530021

英文单位：Department of Obstetrics the People′s Hospital of Guangxi Zhuang Autonomous Region Nanning 530021 China

关键词：静脉血栓栓塞；血栓风险评估表；D-二聚体

英文关键词：Venousthromboembolism;Thrombosisriskassessmenttable;D-dimer

• 摘要：

• 目的 探讨血浆D-二聚体联合英国皇家妇产科医师学会（RCOG）血栓风险评估表对产妇静脉血栓栓塞（VTE）的诊断价值。方法  选取2019年1—6月于广西壮族自治区人民医院分娩的611例产妇为研究对象，依据产妇接受的检测方式不同，分为对照组（293例）和观察组（318例）。所有产妇于产前、产后48~72 h检测D-二聚体水平，观察组在此基础上联合产后48~72 h RCOG血栓风险评估表。以CT/磁共振成像等影像学检查为产妇VTE诊断的“金标准”，分析血浆D-二聚体联合RCOG血栓风险评估表对产妇VTE的预测价值。结果 观察组产妇VTE检出率高于对照组［37.1%（118/318）比18.1%（53/293）］，差异有统计学意义（χ2=17.375，P=0.001）。观察组阴性预测值、阳性预测值、敏感度、特异度、准确度均高于对照组，漏诊率、误诊率均低于对照组，差异均有统计学意义（均P＜0.05）。结论  血浆D-二聚体联合RCOG血栓风险评估表在诊断产妇VTE中具有较高的敏感度、特异度及准确度。

• Objective   To study the diagnostic value of plasma D-dimer combined with Royal College of Obstetricians and Gynaecologists (RCOG) thrombosis risk assessment table in maternal venous thromboembolism (VTE). Methods   From January to June 2019, 611 puerperants who were delivered in the People′s Hospital of Guangxi Zhuang Autonomous Region were enrolled. According to different detections, they were divided into the control group (293 cases) and the observation group (318 cases). The level of plasma D-dimer was detected in all puerperants before delivery and 48-72 h after delivery, and the observation group was combined with RCOG thrombosis risk assessment table 48-72 h after delivery. Imaging examinations such as CT/magnetic resonance imaging were the "gold standard" for the diagnosis of maternal VTE. The predictive value of plasma D-dimer combined with RCOG thrombosis risk assessment table in maternal VTE was analyzed. Results  The detection rate of maternal VTE in the observation group was higher than that in the control group ［37.1%（118/318） vs 18.1%（53/293）］ (χ2=17.375, P=0.001). The negative predictive value, positive predictive value, sensitivity, specificity and accuracy in the observation group were higher than those in the control group, and missed diagnosis rate and misdiagnosis rate in the observation group were lower than those in the control group (all P<0.05). Conclusion Plasma D-dimer combined with RCOG thrombosis risk assessment table has high sensitivity, specificity and accuracy in diagnosing maternal VTE.