Construction and application of diagnostic model for lower extremity deep venous thrombosis in patients with spinal surgery

English Keywords:Spine surgery  Deep venous thrombosis  Diagnosis  Detection rate  Effect analysis

English Abstract:

  【Abstract】 Objectives: To apply the best evidence for the diagnosis of deep venous thrombosis in the diagnosis model among spinal surgery patients, in order to improve the early diagnosis of deep venous thrombosis. Methods: The diagnosis model of deep venous thrombosis based on best evidence was retrieved. Combined with clinical scenarios and professional judgment, the best evidence for the diagnosis of 5 deep venous thrombosis was finally included, and evidence-based thrombus diagnostic model screening based on best evidence was developed. A total of 443 patients in the perioperative period who were hospitalized in the spinal surgery ward of the Second Xiangya Hospital of Central South Unviersity from January to May 2018 were selected to adopt the traditional thrombosis diagnosis process(traditional method group), that was, when DVT clinical manifestations or D-dimer detection values were significantly higher than the positive threshold value, B-ultrasound of lower limbs was adopted to screen and diagnose DVT in patients. From July 1, 2018 to November 30, 2018, 498 perioperative patients hospitalized in the same ward underwent an evidence-based DVT screening diagnosis process(new method group). Before and after the application of evidence-based DVT screening and diagnosis procedures, the incidence of DVT in perioperative patients of spinal surgery and the occurrence of DVT clinical manifestations, such as lower limb swelling, pain, and purple and dark skin color, occurred in patients diagnosed with DVT were compared. The proportion of peripheral types in clinical classification of DVT of the patients was analyzed by checking the B-ultrasonic examination report sheet of both lower limbs. Results: The incidence of deep venous thrombosis in traditional method group and new method group was 2.93% and 19.28% respectively. The difference between the two groups was statistically significant(P<0.05). The incidence of symptomatic DVT in patients with deep venous thrombosis was respectively 100%, 18.75%, the difference between the two groups was statistically significant(P<0.05). Among those deep vein thrombosis of the lower extremity patients, the peripheral deep venous thrombosis was respectively 7.69% and 95.83%. The difference between the two groups was statistically significant(P<0.05). Conclusions: Evidence-based practice of the deep venous thrombosis diagnosis can improve the detection rate of deep venous thrombosis among the perioperative period of spinal surgery patients ,which can achieve early diagnosis of deep venous thrombosis.