严重创伤患者D-二聚体水平的变化及意义  

Plasma D-dimmer levels in patients with severe trauma and its clinical significance

作　　者：何革[1] 吴川峰[2] 陈春悦[3] 

机构地区：[1]浙江省中西医结合医院外科,杭州310003 [2]浙江中医药大学第二临床学院 [3]浙江省中西医结合医院中心实验室,杭州310003

出　　处：《浙江医学》2013年第8期645-646,660,共3页Zhejiang Medical Journal

摘　　要：目的探讨严重创伤患者D-二聚体水平的变化及意义。方法选取严重创伤患者411例(创伤组)及体检健康者400例(对照组)。创伤组患者分别于术后24、96h抽血,以胶体金免疫渗透试验定量检测D-二聚体水平。对照组一次抽血检测D-二聚体水平。结果创伤组术后24、96h的D-二聚体阳性率及水平均显著高于对照组(均P<0.01)。创伤组中38例(9.2%)术后发生创伤性深静脉血栓(TDVT),术后24、96h的D-二聚体水平均明显高于对照组(均P<0.01)。创伤组中未发生TDVT的373例患者术后24、96h的D-二聚体水平均明显低于发生TDVT者(P<0.05或0.01)。发生TDVT者术后24h的D-二聚体高水平者(1.9%)显著多于未发生TDVT者(65.8%),差异有统计学意义(P<0.01)。结论血浆D-二聚体水平的监测对严重创伤患者TDVT的发生具有一定的提示意义,对患者的治疗及预后亦具有重要意义。Objective To evaluate the clinical significance of plasma D-dimmer levels in patients with severe trauma. Methods Four hundred and eleven patients with severe trauma （trauma group） and 400 healthy subjects （control group） were in-cluded in this study. The plasma D-dimmer levels were measured by col oidal gold immune infiltration method in controls and in trauma patients at 24 and 96h after surgery respectively. Results The D-dimmer positive rate and plasma levels at 24 and 96h after surgery in trauma patients were significantly higher than those of normal controls （P〈0.01）. Traumatic deep vein thrombosis （TDVT） developed in 38 patients （9.2%）, whose 24 and 96 h D-dimmer levels were significantly higher than that of control group （both P〈0.01） and 373 trauma patients without TDVT developed （P〈0.05 or 0.01）. The rate of high D-dimmer levels at 24h in TDVT patients was significantly higher than that in non-TDVT trauma patients （65.8%, 1.9%, P〈0.01）. Conclusion High plasma D-dimmer level may indicate the development of traumatic deep vein thrombosis in patients with severe trauma.

关 键 词：创伤 创伤性深静脉血栓 D-二聚体 

分 类 号：R641[医药卫生—外科学]