髋关节置换后监测D-二聚体、纤维蛋白原及纤维蛋白降解产物对诊断预防下肢深静脉血栓的临床意义  

The clinical significance of monitoring the two D-dimmer, fibrinogen and fibrin degradation products in preventing deep vein thrombosis after hip replacement

作　　者：牛云峰[1] 李广贤[1] 刘金榜[1] 许金松[1] 

机构地区：[1]河南省安阳地区医院骨科,河南安阳455000

出　　处：《中国医药科学》2014年第8期16-19,共4页China Medicine And Pharmacy

摘　　要：目的检测人工全髋关节置换术前、术后血浆纤维蛋白原,纤维蛋白降解产物,D-二聚体含量变化,探讨其对诊断及预防下肢深静脉血栓形成的临床指导意义。方法选择人工全髋关节置换患者133例,根据术后有无DVT将其分为DVT组和Control组,分别于入院后1d、术后1d、7d、14d检测凝血功能纤维蛋白原(FIB)、纤维蛋白降解产物(FDB)、D-二聚体(D-dimer),并进行分析比较。结果血浆FIB含量在手术前后Control组和DVT组差异无统计学意义,术后两组均有一过性升高趋势,但术后14d降至正常;FDB手术前后两组差异无统计学意义(P>0.05),Control组术前含量较低,术后同样有一过性升高趋势,术后14d逐渐降低,术后各个时间点同术前比较差异有统计学意义(P<0.05),DVT组术前FDP含量较高,术后1d达峰值,之后逐渐下降,各时间点差异无统计学意义(P>0.05);D-dimer术后两组含量逐渐增高,术后7d、14d同术前比较差异有统计学意义(P<0.05),术后7d、14d DVT组含量显著高于Control组,差异有统计学意义(P<0.05)。结论纤维蛋白原、纤维蛋白降解产物和D-二聚体的检测在低分子肝素预处理后的人工全髋关节置换术后DVT的早期预防及治疗上具有临床应用价值,尤其是D-二聚体是诊断深静脉血栓的实验室无创伤检查的首选方法。Objective To study the clinical significance of determination of plasma fibrinogen （FIB）, fibrin degradation products （FDB）, D-dimer （D-dimer） content on of total hip arthroplasty for prevention of deep venous thrombosis of lower extremity. Methods One hundred and thirty-three cases of patients undergoing total hip arthroplasty was divided into DVT groups and control groups according to the presence or absence of postoperative DVT respectively, after admission 1d, after 1d, 7d, 14d detect coagulation FIB, FDB, D-dimer and were analyzed and compared. Results Plasma FIB levels before and after surgery difference was not statistically significant between in both groups, after a transient increase trend, but returned to normal after 14d; Each time point after operation were compared with preoperative had statistical significance （P0.05）;D-dimer after operation in the two groups were gradually increased, with statistical significance after 7d, 14d preoperative difference （P〈0.05）, after 7d, 14d in DVT group was significantly higher than that in control group, the difference was statistically significant （P〈0.05）. Conclusion The detection of FIB, FDB and D-dimer in early prevention and treatment of DVT total hip arthroplasty in low molecular weight heparin pretreated after has clinical application value, especially D-dimer is the preferred method for diagnosis of deep venous thrombosis of the non-invasive examination of laboratory.

关 键 词：人工全髋关节置换 纤维蛋白原 D-二聚体 深静脉血栓 

分 类 号：R684[医药卫生—骨科学]