下肢骨折并发静脉血栓性疾病的临床分析

Clinical analysis on lower limb fractured patients accomplished with venous thromboembolism

目的通过分析住院下肢骨折患者并发静脉血栓性疾病(VTE)的相关临床资料,总结出下肢骨折患者并发VTE的发病特点及临床防治方法。方法回顾性分析307例下肢骨折患者临床资料,其中54例经B超、肺动脉CT造影(CTPA)检查明确并发静脉血栓性疾病,对以上患者进行临床及血液学等指标对比分析。结果男性患者202例,并发VTE 31例,发病率15.4%;女性患者105例,并发VTE 23例,VTE发病率21.9%。总VTE发病率17.6%。血栓组患者纤维蛋白原(FIB)在VTE发病前后差异有统计学意义。D-二聚体灵敏度61.6%,特异度85.3%。结论 VTE在下肢骨折患者中具有很高的发病率,尤其是在髋关节及膝关节周围骨折患者中。单纯以D-二聚体作为VTE诊断具有一定限制性,需结合临床表现及相关影像学检查进行临床诊断。FIB对诊断VTE有辅助作用。

Objective To investigate the clinical features, prevention and therapy of VTE in lower limb fractured patients. Methods The clinical and lab data of 307 patients and 54 of them were diagnosed VTE were retrospectively analyzed by ultrasound and CTPA between May 2010 and May 2011. Results The incidence of VTE was 15.4% in male and 21.9% in female,respectively. The total incidence of VTE was 17.6%. The data of FIB in patients who accomplished with VTE had significant difference before and after VTE. The sensitivity of D - dimer was 61.6% and specificity was 85.3% in this study. Conclusion The lower limb fractured patients have higher incident accom- plished with VIE,especially in peripheral hip joint fracture patients and peripheral knee joint fracture patients. D -dimer has restriction when used as the standard method to diagnose VTE. The clinical diagnosis of VTE is made by the clinical manifestation combined the imageology. FIB is useful in VTE diagnosis and it is important to diagnosis VTE as soon as possible and to treatment rationally.