严重四肢骨折患者血浆中D-二聚体的变化及其临床意义

Changes and Clinical Significance of D-dimer in Plasm of the Patients with Severe Fractures of Upper and Lower Limbs

目的 探讨严重四肢骨折并消化道出血的发病因素。方法 对 71例严重四肢骨折患者采用乳胶凝集法 (半定量法 )测定血浆中D -二聚体。结果 严重四肢骨折患者伤后 1、 3d ,1、 2周血浆中D -二聚体浓度均比正常对照组呈不同程度的增高 (P <0 0 1) ;同时显示 :严重四肢骨折患者合并消化道出血组与不合并消化道出血组血浆中D -二聚体含量存在显著性差异 (P <0 0 5 )。结论 严重四肢骨折并消化道出血的发病因素与凝血机制异常有关。

Objective To study pathogenic element on gastrointestinal bleeding following severe fractures of upper and lower limbs.Methods D-dimer in plasm of seventy-one patients admitted between January 2002 and February 2003 with severe fractures of upper and lower limbs were determined by lacteprene coagulation method (haif-quantification).Results Plasma D-dimer levels in all seventy-one patients with severe fractures of upper and lower limbs were significantly higher at 1st,3rd,7th, 14th day of postinjury than those of the normal control group (P<0.01 ).There were significantly difference between the patients with gastrointestinal bleeding following severe fractures of upper and lower limbs and the patients with non-gastrointestinal bleeding following severe fractures of upper and lower limbs(P<0.05).Conclusion The pathogenic element of gastrointestinal bleeding following severe fractures of upper and lower limbs is related to blood coagulation disfunction.