股骨粗隆间粉碎性骨折患者围手术期凝血功能和氧化应激指标的变化

Analysis of the Changes of Coagulation Function and Oxidative Stress during Perioperative Period in Patients with Intertrochanteric Fracture

目的探究股骨粗隆间粉碎性骨折患者围手术期凝血功能和应激水平的变化。方法选取2015年1月至2016年12月期间行外科手术治疗的78例股骨粗隆间骨折患者为实验组,同期健康体检者78例为对照组。通过采集两组患者术前1天(T0)和术后第1天(T1)、第3天(T2)、第5天(T3)、第7天(T4)的静脉血液10 mL,用于血小板、凝血指标和氧化应激指标的检测,并进行比较。结果对照组比较显示,骨折组患者除了D二聚体指标,凝血和血小板指标在术前均无统计学意义(P>0.05),术后凝血指标,血小板计数虽有波动但均属正常范围。骨折组患者的氧化应激指标在术前均无统计学意义(P>0.05),术后1 d,SOD和MDA均显著增高(P<0.05),术后5 d,各个指标不同程度的改善,到术后7 d,SOD和MDA得到显著的改善。实验组患者术后均未出现DVT或肺栓塞及其伤口大出血等并发症情况。结论在股骨粗隆间骨折患者的围术期中,测定患者机体的凝血指标和氧化应激指标关系可作为对患者术后预后的评价指标之一。

Objective To investigate the changes of coagulation function and stress level in patients with intertrochanteric fracture during perioperative period. Methods 78 cases of intertrochanteric fracture were treated as the experimental group, and 78 healthy subjects as control group at the same time from January 2015 to December 2016. Through the acquisition of two groups of patients before 1 days （T0）and the first day after operation （ T1 ）, third days （ T2）, fifth days （ T3 ）, seventh days （ T4 ） for the detection of the venous blood 10 mL,blood platelet,blood coagulation index and oxidative stress index, And compared. Results Compared to the control group, fracture group patients except two D-dimer index, blood coagulation and platelet index were not statistically significant in the preoperative （ P 〉 0.05 ）, blood coagulation index of postoperative platelet count, despite fluctuations within the normal range. But the fracture group stress oxidation index in preoperative no statistical significance （ P 〉 0. 05 ）, postoperative 1 d, SOD and MDA were significantly increased （P 〈 0. 05 ） ,5 d after operation, improve each index of different degree, to the postoperative 7 d, SOD and MDA are significantly improved. The experimental group did not occur in patients with postoperative DVT or pulmonary embolism. Conclusion The relationship between coagulation indexes and oxidative stress indexes in patients with intertrochanteric fracture during perioperative period can be regarded as one of the indexes for evaluating the prognosis of patients with postoperative intertrochanteric fracture.