手外科、骨科患者术后D-二聚体监测价值

The monitoring value of D-dimer of patients after operation in hand surgery and orthopedics department

目的研究手外科、骨科患者术后D-二聚体变化对监测深静脉血栓形成的临床意义。方法随机选取2012年1月~2014年1月入我院手外科、骨科治疗的骨折术后早期（7d内）患者以及经多普勒超声确诊的深静脉血栓（DVT）患者,另选同期接受检查的40例健康体检者作对照。对上述4组的血浆D-二聚体进行检测,并根据年龄分组,分析D-二聚体与深静脉血栓的关系。结果手外科组、骨科组、DVT组的D-二聚体（D-D）与健康对照组比较有明显增高,差异有统计学意义（P〈0.05）,特别是骨科组、DVT组两组显著增高（P〈0.01）,手外科组、骨科组、DVT组D-D阳性率分别为14.21%、67.18%、90.00%。按年龄分高龄组（≥50岁）和低龄组（〈50岁）,不同创伤患者D-D与健康对照组比较有明显增高,差异有统计学意义（P〈0.05）,高龄组与低龄组D-D比较差异有统计学意义（P〈0.05）。结论年龄≥50岁的骨科创伤患者术后D-二聚体增高应警惕DVT的发生,且D-二聚体增高有助于临床医生尽早采取治疗措施,对创伤患者的治疗和预后有十分重要的临床意义。

Objective To study the clinical significance of deep venous thrombosis by monitoring D-dimer changes of the patients after operation in hand surgery and orthopedics department. Methods Randomly selected paitents＇ D-dimer after fracture operation （〈7 days） from hand surgery and orthopedics department. And also chosed the patients diagnosed with DVT by the doppler ultrasound. Selected the value of 40 healthy cases as control group. Analyzed the relationship between D-dimer and DVT according to the different age group. Results D-dimer of hand surgery group, fracture group, DVT group were higher than the values of healthy control group and the difference was statistically significant （P〈0.05）. The values of fracture group, DVT group were significantly higher （P〈0.01）, the positive rate of hand surgery group, orthopedics department and DVT group were 14.21%, 67.18%, 90.00%. The values of D-dimer of the two different age group, elder group （~〉50 years） and younger group （〈50 years） were more higher than that of control group. And the difference between the elder group and younger group was statistically significant （P〈0.05）. Conclusion The operation patients who are older more than 50 years should be considered in the occurrence of DVT, it is useful for the doctor to take meatures to treat it. It has an important clinical significance for the treatment and prognosis of trauma patients.