D-二聚体及纤维蛋白原检测在老年下肢骨折术后并发深静脉血栓中的临床意义

Clinical significance of testin g plasma D-dimer and fibrinogen on the postoperative deep vein thrombosis in the elder with lower limb fractures

目的探讨D-二聚体(D-D)和纤维蛋白原(Fbg)检测在老年下肢骨折术后并发深静脉血栓(DVT)中的临床意义。方法对2012年3月至2013年7月收治的90例老年下肢骨折患者(研究组)分别在术前、术后第3天进行血浆D-D和Fbg检测,并根据彩色多普勒超声检查结果加以分析。研究组以是否并发DVT分为并发DVT组和未并发DVT组。同时选取健康体检者60例作为对照组。比较三组血浆D-D和Fbg水平。结果90例老年下肢骨折患者术后有11例并发DVT,并发DVT组和未并发DVT组术前D-D及Fbg水平均较对照组升高,差异有统计学意义(P<0.05);并发DVT组术后第3天血浆D-D和Fbg水平均高于术前,差异有统计学意义(P<0.01);未并发DVT组术前D-D和Fbg水平与术后第3天比较,差异均无统计学意义(P>0.05)。并发DVT组与未并发DVT组术前血浆D-D及Fbg水平比较,差异无统计学意义(P>0.05),术后第3天血浆D-D和Fbg水平比较,差异有统计学意义(P<0.01)。结论血浆D-D和Fbg检测对老年下肢骨折术后并发DVT的早期诊断和预防具有重要临床意义。

Objective To explore the clinical significance of the testing plasma D-dimer（D-D） and fibrinogen（Fbg） on the postoperative deep vein thrombosis in the elder with lower limb fractures. Methods Totally 90 elderly patients with lower limb fractures（study group） who were enrolled from March 2012 to June 2013,were selected to be carried out the test on plasma D-D and Fbg before the operation,and at the 3rd day after the operation respectively,and the results were analyzed by Color Doppler ultrasonography. Meanwhile ,other 60 healthy subjects were taken as the control group ,and the plasma D-D and Fbg lev-els were compared between the two groups. Results 11 cases concurred deep vein thrombosis （DVT） in 90 elderly patients with lower limb fractures.The D-D and Fbg levels in the DVT group on 3rd after operation were both significantly higher than those before operation（P0.05）. The D-D and Fbg levels before the operation had no statistically significant difference between the DVT group and non-DVT group（P〉0.05）,but the difference between the two groups on D-D and Fbg levels on 3rd d after op-eration was statistically significant（P〈0.01）. Conclusions The testing of the plasma D-D and Fbg has remarkable clinical signif-icance on the early diagnosis and prevention of the postoperative deep vein thrombosis for the elder with lower limb fractures.