髋部骨折围手术期患者D-二聚体测定的临床意义

CLINICAL SIGNIFICANCE OF MONITORING PERIOPERATIVE D -DIMER IN HIP FRACTURE PATIENTS

目的探讨老年髋部骨折手术前后D-二聚体(D-dimer,DD)含量的影响因素以及与并发症的相关性,为临床预防、治疗并发症提供依据。方法回顾性总结老年骨折患者围手术期DD的测定结果,将78例DD检测数值进行手术前后及连续监测值对比,分析DD变化与并发症的关系。测定方法采用胶体金免疫渗透试验。结果 78例术前DD阳性57例(73%),术后阳性61例(78%),术后并发症19例(24%),其DD值明显升高。老年骨折术后患者血浆中DD阳性率高于正常人群,术前并发症导致DD升高,其手术并发症的发生率也相应升高。结论老年髋部骨折患者血浆中DD含量与并发症成正相关。围手术期常规检测DD对判断、预防手术并发症有重要意义。

Objective To discuss the influencing factors of D -dimer（DD） in the perioperative period and the correlation between the value and complications in elderly patients with hip fracture and to provide definite evidence for prevention and treatment of complications. Methods A retrospective analysis was done to evaluate the value of DD in 78 elderly patients with hip fracture. The value of DD was compared between preoperative and postoperative and successive monitoring. The correlation between DD value and complications in preoperative were analyzed. The method of gold colloids immunofihration was used. Results Among 78 cases, DD were positive in 57 cases in preoperative and 61 cases in postoperative respectively, complications were occurred in 19 cases in postoperative and the DD value increased obviously. In general, DD positive rate in the elderly postoperative patients with hip fractures was higher than normal people. Preoperative complication could lead to DD value increasing, morbidity of postoperative complications also increased. Conclusion The value of DD in plasma in elderly patients with hip fractures shows a positive correlation with complications. Measurement of DD routinely is of important significance for the judgement and prevention of operative complications in perioperativc period.