多发性创伤患者血浆F_(1+2)、D-二聚体、FIB的检测

Detection of plasm F_(1+2),D-Dimer,FIB levels in multiple-injury trauma patients

目的研究多发性创伤患者血浆D-二聚体、F1+2、FIB浓度变化的意义。方法选取32例多发性创伤患者进行D-二聚体、凝血酶原裂解片段(F1+2)、纤维蛋白原(FIB)检测,与30例正常对照组进行比较。同时动态观察多发性创伤患者术前、术后第1天和第4天静脉血分析各项指标变化情况,其中并发弥漫性血管内凝血(DIC)者(DIC组)9例,未并发DIC组者(非DIC组)23例。结果术后第1天与对照组结果比较F1+2、D-二聚体、FIB等差异均有统计学意义(P<0.01)。F1+2和D-二聚体手术后第4天与手术后第1天差异无统计学意义(P>0.05)。FIB手术后第4天与手术前差异无统计学意义(P>0.05),但FIB手术后第1天与手术前和手术后第4天比明显增高(P<0.05)。DIC组的F1+2、D-二聚体、FIB水平显著高于非DIC组。结论F1+2、D-二聚体、FIB可作为监测严重创伤患者凝血纤溶状态的相当有价值的指标,对DIC的早期诊断、治疗有重要意义。

Objective To investigate the significance of the concentration variety of plasma D-dimer,deposition of prothrombin （F1＋2） and fibrinogen（FIB） in patients with multiple trauma. Methods The D-dimer,F1＋2 ,FIB of 32 patients with multiple trauma were measured and compared with 30 cases normal reference group. The analyse-indexes diversification of the vein blood collected from the multiple trauma were observed on both the first and the fourth day before and after the operation（OPS. ）. And there were 9 cases with DIC syndrome,23 cases without it. Results The F1＋2 ,D-dimer and FIB were all distinctly different from the reference group on the first day after OPS（P〈0.5） ,And F1＋2 as well as D-dimer on the fourth day were not in remarkable difference compared to the ones on the first day after OPS（P〉0.05）. There was no remarkable diversity in FIB between the fourth day after OPS and before OPS（P〉0.05）. Yet FIB obviously heighten on the first day after OPS. compared to the fourth day before and after OPS. （P〈0.05）. and F1＋2 ,D-Dimer and FIB level of DIC group were obvious higher than DIC group. Conclusion F1＋2, D-dimer and FIB can be regarded to be valuable indexes of supervising Trauma Patients＇ coagulation - fibrinolysis state,and have important significance in diagnose and therapy of DIC.