血栓弹力图预测粗隆间骨折围术期血栓形成的诊断价值  

Diagnostic Value of Thrombelastogram in Predicting Perioperative Thrombosis of Intertrochanteric Fractures

作　　者：王大城[1] 张彦[1] 郭汉明[1] 黄杰华[1] 王新光[1] 张理想 康明[1] WANG Dacheng;ZHANG Yan;GUO Hanming;HUANG Jiehua;WANG Xinguang;ZHANG Lixiang;KANG Ming(Department of Joint Surgery,Huizhou Central People’s Hospital,Huizhou 516000,China)

机构地区：[1]惠州市中心人民医院关节外科,广东惠州516000

出　　处：《临床医学工程》2021年第1期13-14,共2页Clinical Medicine & Engineering

基　　金：惠州市科技计划项目(项目编号:2019Y017)。

摘　　要：目的探讨血栓弹力图(TEG)预测粗隆间骨折围术期血栓形成的诊断价值。方法选取90例行闭合复位髓内钉内固定的股骨粗隆间骨折患者90例,术后彩超检查明确血栓,根据检查结果分为血栓组(n=35)和非血栓组(n=55)。对比两组的TEG相关参数及凝血功能五项,分析TEG预测粗隆间骨折围术期血栓形成的价值。结果术前及术后1 d、 7 d,血栓组的R值、 K值均低于非血栓组,α角、 MA值、 FIB、 D-D均高于非血栓组(P <0.05)。TEG各参数联合评估的灵敏度、特异度均显著高于单项评估(P <0.05)。结论 TEG预测股骨粗隆间骨折围术期血栓形成具有较高的诊断价值,值得临床推广应用。Objective To explore the diagnostic value of thrombelastogram(TEG)in predicting perioperative thrombosis of intertrochanteric fractures.Methods 90 patients with intertrochanteric fractures undergoing internal fixation with closed reduction and intramedullary nail were selected.The thrombosis was confirmed by postoperative color ultrasound examination,and the patients were divided into thrombosis group(n=35)and non-thrombosis group(n=55)according to the examination results.The TEG related parameters and five coagulation function parameters were compared between the two groups,and the value of TEG in predicting perioperative thrombosis in intertrochanteric fractures was analyzed.Results Before surgery and 1 day and 7 days after surgery,the R values and K values of the thrombosis group were lower than those of the non-thrombosis group,and the α angle,MA values,FIB and D-D were higher than those of non-thrombosis group(P<0.05).The sensitivity and specificity of combined evaluation of TEG parameters were significantly higher than those of single evaluation(P<0.05).Conclusions TEG has higher diagnostic value in predicting perioperative thrombosis of intertrochanteric fractures,which is worthy of clinical promotion and application.

关 键 词：粗隆间骨折 血栓 血栓弹力图 凝血功能 

分 类 号：R687.3[医药卫生—骨科学]