2026 年第 4 期 第 21 卷

Caprini评分联合D-二聚体对消化道肿瘤患者术后静脉血栓栓塞的预测价值

Predictive value of Caprini score combined with D-dimer for postoperative venous thromboembolism in patients with gastrointestinal tumors

作者：孙亚珂张红靳帅路帅

英文作者：Sun Yake Zhang Hong Jin Shuai Lu Shuai

单位：首都医科大学附属北京安贞医院普外科，北京100029

英文单位：Department of General Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：消化道肿瘤；Caprini评分；D-二聚体；静脉血栓栓塞

英文关键词：Gastrointestinaltumors;Capriniscore;D-dimer;Venousthromboembolism

• 摘要：

• 目的 探究Caprini评分联合D-二聚体对消化道肿瘤患者术后静脉血栓栓塞（VTE）的预测价值。方法 收集首都医科大学附属北京安贞医院普外科2023年2月至2025年2月收治的195例行手术治疗消化道肿瘤患者的临床资料进行回顾性分析。根据术后是否发生VTE将其分为VTE组（20例）和对照组（未发生VTE，175例）。比较2组患者的临床资料、Caprini评分和D-二聚体水平，采用Logistic回归方法分析消化道肿瘤患者术后发生VTE的危险因素，评估Caprini评分和D-二聚体对VTE的预测价值。结果 2组患者年龄、手术时长、术中输血比例差异均有统计学意义（均P<0.05）。术后2组D-二聚体水平均高于术前，且VTE组高于对照组［（467±155）μg/L比（352±170）μg/L］，差异均有统计学意义（均P<0.01）。术后VTE组Caprini评分高于对照组［（7.6±1.3）分比（5.2±1.5）分］，差异有统计学意义（P<0.01）。Logistic回归分析结果显示D-二聚体和Caprini评分异常升高均为消化道肿瘤患者术后发生VTE的独立风险因素（均P<0.001）。D-二聚体和Caprini评分预测消化道肿瘤患者术后发生VTE的曲线下面积（AUC）分别为0.713（95%置信区间：0.593～0.832）和0.875（95%置信区间：0.801～0.949），二者联合的AUC为0.892（95%置信区间：0.827~0.957），联合预测的AUC大于各自单独预测（均P<0.05）。结论 Caprini评分联合D-二聚体对消化道肿瘤患者术后VTE具有较高预测价值，对临床预防术后VTE具有重要参考意义。

• Objective To explore the predictive value of Caprini score combined with D-dimer for postoperative venous thromboembolism (VTE) in patients with gastrointestinal tumors. Methods A retrospective analysis was performed on the clinical data of 195 patients with gastrointestinal tumors who underwent surgical treatment in the Department of General Surgery, Beijing Anzhen Hospital, Capital Medical University from February 2023 to February 2025. According to the occurrence of postoperative VTE, the patients were divided into the VTE group (20 cases) and the control group (without VTE, 175 cases). The clinical data, Caprini score and D-dimer levels were compared between the two groups. Logistic regression analysis was used to identify the risk factors for postoperative VTE in patients with gastrointestinal tumors, and the predictive value of Caprini score and D-dimer for VTE was evaluated. Results There were statistically significant differences in age, operation duration and intraoperative blood transfusion rate between the two groups (all P<0.05). The D-dimer levels of both groups after surgery were significantly higher than those before surgery, and the level in the VTE group was significantly higher than that in the control group ［(467±155)μg/L vs (352±170)μg/L］(all P<0.01). The Caprini score of the VTE group after surgery was significantly higher than that of the control group ［(7.6±1.3) vs (5.2±1.5)］(P<0.01). Logistic regression analysis showed that abnormally elevated D-dimer and Caprini score were independent risk factors for postoperative VTE in patients with gastrointestinal tumors (both P<0.001). The areas under the curve (AUC) of D-dimer and Caprini score for predicting postoperative VTE in patients with gastrointestinal tumors were 0.713 (95% confidence interval: 0.593-0.832) and 0.875 (95% confidence interval: 0.801-0.949), respectively. The AUC of their combination was 0.892 (95% confidence interval: 0.827-0.957), which was higher than that of each single index (both P<0.05). Conclusion Caprini score combined with D-dimer has high predictive value for postoperative VTE in patients with gastrointestinal tumors, which has important reference significance for clinical prevention of postoperative VTE.