骨折患者术前凝血及纤溶功能对术后血栓栓塞症的风险预测  

Items of Blood Coagulation and Fibrinolysis in Preoperative Patients with Fracture on Risk Prediction of Vein Thrombosis

作　　者：胡定祥[1] 林达强[1] 唐天生 何芳[1] 

机构地区：[1]四川省达州市中西医结合医院骨科,635000

出　　处：《医学研究杂志》2015年第7期162-164,共3页Journal of Medical Research

摘　　要：目的：探讨能预测骨折患者术后发生血栓栓塞症的凝血与纤溶指标。方法收集2012年2月-2013年12月入笔者医院行骨折手术并术前行螺旋CT、彩色多普勒超声或血管造影等影像学检查的患者321例，其中发生静脉血栓栓塞症的患者13例设为A组，无静脉血栓栓塞症的患者308例设为B组，选取同期健康体检人员150例作对照组，分别检测凝血及纤溶系统各指标。结果与对照组相比，A组与B组的TT值比较，差异无统计学意义（P＞0．05）；PLT、FIB、AT－Ⅲ值显著升高且A组高于B组（P＜0．05），但其值仍处于或接近正常范围；APTT与PT值显著降低且A组低于B组（P＜0．05），但其值也仍处于或接近正常范围；D－D值进行性升高，A组显著高于B组且A组显著超出正常参考范围（P＜0．001）。结论凝血及纤溶功能各项指标中，PLT、APTT、PT、TT、FIB及AT－Ⅲ对术后发生血栓栓塞症的风险预测不足，只有D－D值可能对骨折术后静脉血栓栓塞症的发生具有良好预测作用。Objective To investigate the items of blood coagulation and fibrinolysis in preoperative patients with fracture on risk pre-diction of vein thrombosis predictive.Methods A total of 321 patients suffered fractures with spiral CT, color Doppler ultrasonography and angiography imaging examination before fracture surgery were retrospectively analyzed from February 2012 to December 2013, of whom （13 cases） underwent vein thrombosis set to group A , of what （308 cases） not underwent vein thrombosis set to group B and the same period in healthy volunteers 150 selected as control group.The items of blood coagulation and fibrinolysis were detected.Results Com-pared with the control group, TT values of group A and group B had no significant difference （P〉0.05）.PLT, FIB, AT-Ⅲwere sig-nificantly higher in group A than in group B （P〈0.05）, but its values still at or near the normal range.APTT and PT values were signif-icantly lower in group A than in group B （P〈0.05）, but its value was also at or near the normal range.DD value was increased,and group A was significantly higher than group B and group A was significantly beyond the normal reference range （P〈0.001）.Conclusion PLT, APTT, PT, TT, FIB and AT-Ⅲwere deficiency for predication the risk of vein thrombosis of patients with fractures, only DD may can finely predict the risk of vein thrombosis postoperative of patients with fractures.

关 键 词：骨折 凝血功能 血栓栓塞症 

分 类 号：R4[医药卫生—临床医学]