TT、FIB、D-D用于二次创伤骨折术后深静脉栓塞风险评估的价值  

Value of TT,FIB,and D-D in risk assessment of deep vein embolism after secondary traumatic fracture

作　　者：吴继宏 欧阳国林 陈涛[2] 邵微刚 容向宾[2] WU Jihong;OUYANG Guolin;CHEN Tao;SHAO Weigang;RONG Xiangbin(Department of Emergency,Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning 530001,China;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Guangxi Zhuang Autonomous Region,Nanning 530001,China)

机构地区：[1]广西中医药大学附属瑞康医院急诊科,广西南宁530001 [2]广西中医药大学附属瑞康医院骨科,广西南宁530001

出　　处：《中国医药导报》2023年第21期84-87,共4页China Medical Herald

基　　金：广西壮族自治区自然科学基金青年基金资助项目(2020GXNSFBA159053)。

摘　　要：目的分析凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)用于二次创伤骨折术后深静脉血栓形成(DVT)风险评估的价值。方法选取2019年1月至2022年7月广西中医药大学附属瑞康医院收治的二次创伤骨折患者100例,根据术后是否发生DVT分为DVT组41例与非DVT组59例。使用单因素及多因素logistic回归分析术后DVT的独立危险因素,绘制受试者操作特征(ROC)曲线评价TT、FIB和D-D对术后DVT的预测价值。结果DVT组TT低于非DVT组,FIB、D-D高于非DVT组,差异有统计学意义(P<0.05);两组PT、APTT比较,差异无统计学意义(P>0.05)。logistic回归分析结果显示,全身麻醉[OR(95%CI)=2.194(1.626~2.960)]、术中输血[OR(95%CI)=2.458(1.780~3.394)]、FIB[OR(95%CI)=1.483(1.244~1.768)]和D-D[OR(95%CI)=2.026(1.610~2.549)]是二次创伤骨折术后DVT发生的独立危险因素(P<0.05);TT[OR(95%CI)=0.868(0.774~0.973)]是术后DVT发生的独立保护因素(P<0.05)。TT、FIB、D-D联合预测术后DVT发生的曲线下面积为0.914,灵敏度为0.927,特异度为0.878。结论TT、FIB和D-D是二次创伤骨折术后DVT发生的独立影响因素,三项联合可作为术后DVT发生的灵敏度预测指标。Objective To analyze the value of thrombin time(TT),fibrinogen(FIB),and D-dimer(D-D)in the risk assessment of deep vein thrombosis(DVT)after secondary traumatic fracture.Methods A total of 100 patients with secondary traumatic fracture admitted to Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from January 2019 to July 2022 were selected and divided into DVT group(41 cases)and non-DVT group(59 cases)according to whether DVT occurred after operation.Univariate and multivariate logistic regression analysis were used to analyze the independent risk factors of postoperative DVT,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of TT,FIB,and D-D in postoperative DVT.Results TT in DVT group was lower than that in non-DVT group,FIB and D-D were higher than those in non-DVT group,and the differences were statistically significant(P<0.05).There was no significant difference in PT and APTT between the two groups(P>0.05).logistic regression analysis results showed that,general anesthesia(OR[95%CI]=2.194[1.626-2.960]),intraoperative blood transfusion(OR[95%CI]=2.458[1.780-3.394]),FIB(OR[95%CI]=1.483[1.244-1.768]),and D-D(OR[95%CI]=2.026[1.610-2.549])were independent risk factors for DVT after secondary traumatic fracture(P<0.05);TT(OR[95%CI]=0.868[0.774-0.973])was an independent protective factor for DVT after secondary traumatic fracture(P<0.05).The area under the curve predicted by the combination of TT,FIB and D-D was 0.914,the sensitivity was 0.927,and the specificity was 0.878.Conclusion TT,FIB,and D-D are independent influencing factors for DVT after secondary traumatic fracture,and the combination of these three factors can be used as a sensitive predictor of postoperative DVT.

关 键 词：凝血酶时间 纤维蛋白原 D-二聚体 二次创伤骨折 深静脉血栓形成 

分 类 号：R651[医药卫生—外科学]