凝血和纤溶指标对骨科创伤患者下肢静脉血栓的评价  

作　　者：施晓成[1] 汪剑龄[1] 陈约东[1] 周胜[1] 彭赛[1] 李颖[1] 

机构地区：[1]中国人民解放军第四五四医院骨科,江苏南京210002

出　　处：《浙江临床医学》2017年第4期642-643,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨凝血和纤溶指标对骨科创伤患者下肢静脉血栓的评估价值方法选取2014年1月-2016年5月在本院住院并手术的创伤患者230例，术前与术后分别对患者行下肢深静脉彩色多普勒超声检查，测定血浆凝血酶原时间（PT）、纤维蛋白酶（Fbg）、纤维蛋白降解产物（FDP）、活化部分凝血酶原时间（aPTT）、D-二聚体（D-D），同时分析血糖、血压、性别及年龄与血栓形成的关系。结果230例创伤患者中下肢深静脉血栓37例，发生率16．0％，以小腿肌间静脉血栓为主，糖尿病及高血压患者下肢静脉血栓的发生率明显高于对照组（27．6％VS12．2％：30.3％VS10.3％），差异均有统计学意义（P〈0．05）、术前与术后血栓组DD、FDP及Fbg均明显高于非血栓组；PT与aPTT血栓组与对照组差异均无统计学意义（P〉0．05）.结论检测凝血和纤溶指标有助于下肢深静脉血栓的筛查和诊断，Objective To analysis the evaluation value of blood coagulation and fibrinolytic indexes of lower limb venous thrombosis in patients with orthopaedic trauma. Methods We evaluated 230 patients with traumatic surgery in our hospital from January 2014 to June 2016. Color Doppler ultrasonography was used to detect DVT before and after operation. Plasma prothrombin time （ PT ） , fibrinogen enzymes （ Fbg ） , fibrinogen degradation products （ FDP ） , activated partial prothrombin time （ aPTT ） and D-dimmer （ DD ） were tested.At the same time, we analyzed the relationship among blood glucose, blood pressure, gender, age and thrombosis. Results There were 37 patients with deep vein thrombosis of lower extremity in 230 cases and the incidence of DVT was 16.0%. The incidence of lower extremity venous thrombosis in patients with diabetes and high blood pressure were significantly higher than the control group （ 27.6% vs 12.2%; 30.3% vs 10.3 % ） . Preoperative and postoperative DD, FDP and Fbg in the thrombus group were significantly higher than that non-thrombosis group. The differences of PT and aPTT between the thrombosis group and the control group were not statistically. Conclusion Coagulation and fibrinolysis indicators help to screen and diagnose DVT.

关 键 词：下肢静脉血栓 创伤 凝血 纤溶 

分 类 号：R654.2[医药卫生—外科学]