凝血功能监测在骨折患者中的应用

The Application of Coagulant Function Monitoring in Patients with Fracture

目的探讨不同程度骨折患者血浆中凝血功能指标测定的临床应用价值。方法选择本院2012年1～12月住院骨创伤患者128例，分为单骨折组和多骨折组，另选取对照人群30例；患者在人院时静脉取血送检测定PT、APTT、TT、Fg及D—D，并对3组人群的检测结果进行比较。结果单骨折组与对照组Fg比较差异有统计学意义（P〈O．05），D—D比较差异亦有统计学意义（P〈0．01）；多骨折组与对照组及单骨折组PT比较差异均有统计学意义（P〈0．05），多骨折组与健康组、单骨折组D—D比较，差异均有统计学意义（P〈0．05）。结论对骨折患者视病情严重程度动态监测指标变化，将有效预防血栓性疾病的发生和提高血栓性疾病的早期诊断，PT、Fg、D—D是重要的凝血、纤溶分子标志物，可反映体内凝血和纤溶过程的变化，应重点关注。

Objective To determine the clinical application value of plasma coagulation function in the diagnosis and treatment of the patients with fractures. Methods 128 cases of the inpatients with bone trauma 30 cases of control were collected from January to February, 2012. The patients were divided into the single fracture group and multiple fractures group. Patients on admission received venous blood testing of PT, APTT, TT, Fg, and D-D. The results were compared and anylized. Results There were a difference of Fg between the single fracture group compared with control group （P~ 0. 05）. A statistically significant difference of D-D was noted （P〈0. 01）. Multiple fractures group, compared with control group and single fracture group ,presented a difference of PT （P〈0.05）. A remarkably significant differences of D-D （P〈 0. 01） was also seen among multiple fractures, single fracture, and controls（P〈0.05）. Conclusion Dynamic monitoring of coagulant factors would help with effective preventing from occurrence of thrombosis and improving the early diagnosis of thrombotic disorders depending on the severity of the patients with fractures. PT,D-D,and Fg are important molecular markers that reflect the change of coagulation and fibrinolysis process.