纤维蛋白原及D-二聚体双动态曲线变化在下肢骨折深静脉血栓预防中的价值  

Significance of dual dynamic curve of Fibrinogen and D-dimer on prediction of deep vein thrombosis in lower limb fractures

作　　者：王刚[1] 李强[1] 徐云钦[1] 姚有榕[1] 申屠刚[1] 

机构地区：[1]解放军第98医院全军创伤骨科中心骨四科,浙江湖州313000

出　　处：《中国骨与关节损伤杂志》2014年第10期1015-1017,共3页Chinese Journal of Bone and Joint Injury

基　　金：南京军区重点课题(ZD03)

摘　　要：目的探讨纤维蛋白原(FIB)及D-二聚体(DD)双动态曲线变化在下肢骨折深静脉血栓(DVT)预防中的临床意义。方法自2007-06—2012-07,共诊治下肢骨折356例,入院后连续3 d每天检测FIB、DD,以后每2 d检测1次,取得FBI与DD双动态变化曲线。根据入院3 d后所测得的曲线变化将患者分为4组,A组(95例)为FIB、DD同时升高者,B组(93例)为FIB降低、DD升高者,C组(86例)为FIB升高、DD降低者,D组(82例)为FIB、DD同时降低者。结果A组8例出现DVT(8.42%),B组5例出现DVT(5.38%),C组1例出现DVT(1.16%),D组未出现DVT。结论观察FIB及DD双动态曲线变化有利于早期预防、发现血栓,指导抗凝治疗,在下肢骨折DVT预防中有着重要的临床意义。Objective To discuss the significance of the significance of dual dynamic curve of Fibrinogen（FIB） and D-dimer（DD） on the prediction of deep vein thrombosis（DVT） in the lower limb fractures. Methods From June 2007 to July 2012,356 patients with lower limb fractures were treated in our department. Plasma DD and FIB were measured preoperatively, at first consecutive 3 days and once 2 days later, the dual dynamic curve of FIB and DD were obtained. All patients were divided into four groups（A,B,C,D） according to the results, FIB and DD elevated simultaneously in group A, FIB lowered while DD elevated in group B, FIB elevated while DD lowered in group C, FIB and DD lowered simultaneously in group D. Results All patients were followed, there were 8 cases of thrombus in 95 cases of group A（8.42%）, 5 cases of thrombus in 93 cases of group B（5.38%）, 1 cases of thrombus in 86 cases of group C（1.16%）, no thrombus in 82 cases of group D. There were significant differences of the incidence of thrombosis in each group（P〈0.05）. Conclusion Dual dynamic curve of Fibrinogen and D-dimer is beneficial to early prevent thrombosis, detect thrombosis, and guide anticoagulation therapy. It has important clinical significance on the prediction of deep vein thrombosis in the lower limb fractures.

关 键 词：下肢骨折 纤维蛋白原 D-二聚体 动态曲线 深静脉血栓 

分 类 号：R619[医药卫生—外科学]