产后检测血浆D-二聚体的临床价值及凝血功能参数变化分析  

The clinical value of detection of postpartum plasma D-dimer and comparative analysis of parameters of antenatal and postpartum coagulation function

作　　者：蔡洁丹[1] 唐万兵[1] 杨小金[1] 王蕾[2] 

机构地区：[1]广东省深圳市龙岗区人民医院检验科,518172 [2]广东省深圳市龙岗区人民医院产科,518172

出　　处：《国际检验医学杂志》2016年第11期1477-1478,1481,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨检测血浆D-二聚体（D-D）对预防产后出血的临床价值及分娩前、后凝血功能参数的变化。方法对547例临产孕妇,根据产后是否发生出血分成产后出血组（16例）和产后未出血组（531例）,分别进行产前24h、产后4h内和产后4~24h内血浆D-D、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（FIB）检测,分析D-D水平变化与产后出血的相关性,对分娩前、后凝血功能参数变化进行统计学分析。结果 （1）产后出血组产后4h内和产后4~24h内D-D、PT和APTT明显高于产前24h,差异有统计学意义（P〈0.05）;（2）产后出血组产后4h内和产后4~24h内TT与产前24h比较差异无统计学意义（P〉0.05）;（3）产后出血组产后4h内和产后4~24h内FIB明显低于产前24h,差异有统计学意义（P〈0.05）;（4）产后出血组产后4h内和产后4~24h内D-D、PT和APTT高于未出血组,差异有统计学意义（P〈0.05）;（5）产后出血组产后4h内和产后4~24h内FIB低于未出血组,差异有统计学意义（P〈0.05）。结论临产前、后检测D-D及密切关注分娩前、后凝血功能参数变化对预防产后出血有一定的临床参考价值。Objective To investigate the clinical value of D-dimer（D-D）in the prevention of postpartum hemorrhage and compare the parameters of antenatal and postpartum coagulation function.Methods To investigate the clinical value of D-dimer（D-D）in the prevention of postpartum hemorrhage and compare the parameters of antenatal and postpartum coagulation function.Results D-D,PT and APTT in 4hours and 4to 24 hours after delivery were significantly higher than that in antenatal 24hours（P〈0.05）in group of postpartum hemorrhage.Compared with TT in the antenatal 24 hours,the differences of that in 4hours and within 4to 24 hours after delivery were not statistically significant in group of postpartum hemorrhage（P〉0.05）.The levels of FIB in the 4hours and within 4to 24 hours after delivery were significantly lower than that in prenatal 24hours（P〈0.05）in group of postpartum hemorrhage.D-D,PT and APTT of postpartum hemorrhage group in the 4hours and within 4to 24 hours after delivery were higher than non-postpartum hemorrhage group（P〈0.05）.FIB of postpartum hemorrhage group in the 4hours and within 4to 24 hours after delivery were lower than non-postpartum hemorrhage group（P〈0.05）.Conclusion The detection of D-D and parameters of antenatal and postpartum coagulation function have clinical reference value for prevention of postpartum hemorrhage.

关 键 词：分娩 D-二聚体 产后出血 凝血功能 

分 类 号：R446.11[医药卫生—诊断学] R714.461[医药卫生—临床医学]