Pilon骨折急诊外固定支架固定对深静脉血栓形成的影响

Effect of external fixation for emergency treatment of pilon fracture on deep venous thrombosis

目的 分析pilon骨折患者急诊外固定支架固定对深静脉血栓形成（DVT）发生率及D-Dimer和Fib浓度的影响.方法 2013年1月至2013年12月收治的单发闭合性pilon骨折予以B超和静脉造影术检查的患者117例,根据是否行急诊外固定支架固定分为急诊外架固定组（18例）和无急诊外架固定组（99例）,比较两组患者的DVT的发生率及D-Dimer和Fib的浓度. 结果 所有患者中共有12例（10.3％）被证实有DVT.且全部为无急诊外架固定组,发生率为12.1％ （12/99）,而急诊外架固定组患者DVT的发生率为0.无急诊外架固定组的平均D-Dimer浓度（620.6 ±228.7） μg/L高于急诊外架固定组（331.5 ±39.7） μg/L,差异无统计学意义（t=0.533,P=0.597）.无急诊外架固定组的平均Fib浓度（378.6±16.6） mg/dL高于急诊外架固定组（290.2±64.4） mg/dL,差异无统计学意义（t=1.882,P=0.068）.结论 急诊外固定支架固定对pilon骨折患者DVT的发生率有影响,对D-Dimer和Fib浓度无影响.

Objective To analyze the effects of external fixation for emergency treatment of pilon fracture on deep venous thrombosis （DVT）,plasma D-Dimer and Fib.Methods Enrolled in this study were 117 patients with simple closed pilon fracture who received B-mode ultrasonic diagnosis and venography.They were grouped according to whether external fixation was applied or not during emergency treatment.Incidence of DVT and concentrations of plasma D-Dimer and Fib were compared between the 2 groups.Results Altogether DVT occurred in 12 cases,giving an incidence of 10.3%.All the cases of DVT were found in the non-external fixation group,giving an incidence of 12.1%,while the DVT incidence was zero in the external fixation group.The D-Dimer concentration was （620.6 ± 228.7） μg/L in the non-external group,insignificantly higher than that in the external group （331.5 ±39.7） μg/L （t =0.533,P =0.597）.The Fib concentration in the non-external group was （378.6 ± 16.6） mg/dL,insignificantly higher than that in the external group （290.2 ±64.4） mg/dL （t =1.882,P =0.068）.Conclusion External fixation for emergency treatment of pilon fracture may have an effect on the incidence of DVT but not on the concentrations of plasma D-Dimer and Fib.