妊娠时期血浆D-二聚体和凝血四项动态监测的临床意义

Clinical Significance of Four Dynamic Monitoring of Plasma D-dimer and Coagulation during Pregnancy

目的分析产妇在不同的妊娠时期其血浆D-二聚体(D-D)以及凝血四项变化并探讨血浆D-D以及凝血四项检测的意义。方法选择我院2017年1月-2017年10月收治的200例产妇作为研究对象;临床针对所有患者的血浆D-D与凝血四项(TT、PT、APTT以及FIB)实施检测;依据产妇妊娠时期情况将之分成早期组(n=52)、中期组(n=50)、晚期组(n=47)以及临产组(n=51),对比各组血浆D-D与凝血四项检测情况。结果随着妊娠期的发展,产妇的血浆D-D水平逐渐升高(P<0.05);妊娠早期组、中期组与晚期组产妇的血浆PT水平对比存在显著差异(P<0.05);各组产妇血浆TT水平未见明显变化(P>0.05);随着妊娠时期的发展,产妇的血浆APTT水平逐渐降低,妊娠早期组与中期组对比存在显著差异(P<0.05);随着妊娠时期的发展,产妇的血浆FIB水平逐渐升高,妊娠早期组与中期组、妊娠晚期组与临产组的对比存在显著差异(P<0.05)。结论针对产妇凝血四项以及妊娠期血浆D-D水平实施动态监测后,针对分娩过程中以及分娩后表现出的出血异常现象可以充分预防,降低DIC以及血栓性疾病的发生风险。

Objective To analyze the changes of plasma D-dimer (D-D) and coagulation in different stages of pregnancy and to explore the significance of plasma D-D and coagulation. Methods 200 cases of maternal women admitted to our hospital from January 2017 to October 2017 were selected as subjects. The plasma DD and coagulation (TT, PT, APTT and FIB) were tested in all patients. According to the maternal pregnancy period The patients were divided into the early group (n=52), the middle group (n=50), the late group (n=47), and the labor group (n=51). The plasma DD and coagulation tests were compared. Results The plasma DD level of pregnant women gradually increased with the development of pregnancy (P<0.05). There was significant difference in plasma PT levels between the early pregnancy group, the intermediate group and the late group (P<0.05). There was no significant change in TT level (P>0.05). With the development of pregnancy, the plasma APTT level of the mother gradually decreased. There was significant difference between the early pregnancy group and the middle group (P<0.05). With the development of pregnancy, The maternal plasma FIB level gradually increased, and there was a significant difference between the early pregnancy group and the middle group, the third trimester group and the labor group (P<0.05). Conclusion After dynamic monitoring of maternal coagulation and plasma D-D levels during pregnancy, the abnormalities of bleeding during and after childbirth can be adequately prevented to reduce the risk of DIC and thrombotic diseases.