摘要
【目的】研究血栓弹力图和D-二聚体在髋关节置换术患者围术期的变化。【方法】观察组为20例股骨颈骨折行髋关节置换术的老年患者,分别于麻醉前(T0)、手术开始后2h(T1)、术后第1天(T2)和术后第3天(L)采静脉血,检测血栓弹力图(TEG)指标(参数为R值、k值、α角、MA、CI)和D-二聚体浓度。另选10例健康人做为对照组。【结果】对照组各项指标均正常。观察组TEG的R值缩短,α角、MA、CI增大,与对照组比较均差异有显著性(P〈0.05),观察组内K值在T2与T0比较差异有显著性(P〈0.05),α在T2与T0比较,MA在T3与T0比较,CI在T2、T3分别与T0比较均差异有显著性(P〈0.05)。观察组D-二聚体明显高于对照组(P〈0.05)。【结论】股骨颈骨折行髋关节置换术患者术前、术中及术后血液呈不同程度高凝状态,术后1~3d有加重趋势,TEG和D-二聚体是判断血液高凝状态的敏感性指标,TEG各项指标中与高凝状态关系密切的是R值、α角、MA、CI。
[ Objective] To explore the perioperative changes of parameters of thromboelastography and D-Dimer in patients undergoing hip replacement. [Methods] Thromboelastography variables (R, K,α angle, MA and CI) and D-Dimer level were measured in 20 aged patients undergoing hip replacement before anesthesia (To), 2 h after operation begining (%), 1 d and 3 d after operation (T2, T3 ) .The control group consists of ten healthy adults. [ Results] All parameters in control group were normal. In hip replacement group, R was shorter, α angle, MA and CI were larger than control group ( P 〈 0.05) .K at T2 was shorter than that at To ( P 〈 0.05), a angle and CI at T2 were larger than that at To ( P 〈 0.05), MA and CI at T3 were larger than that at To (P〈0.05) . D- Dimer/eve/ increased significantly in test group than control group (P〈0.05) [Conclusions] The perioperative patients of hip replacement are in blood hypereoagulable state, and become worse step and step after eration. D - Dimer and TEG are sensitive indexes to evaluate the blood hypereoagulable state. Of TEG indexes, R, α angle, MA and CI are relative strongly to hypercoagtdability.
出处
《武警医学院学报》
CAS
2009年第4期311-314,共4页
Acta Academiae Medicinae CPAPF