多发骨折术后弥散性血管内凝血的危险因素分析

Analysis of Risk Factors for Disseminated Intravascular Coagulation after Operation of Multiple Fractures

目的探讨预测多发骨折术后弥散性血管内凝血(DIC)的危险因素.方法纳入2017年3月至2018年12月间的多发性骨折合并DIC患者作为实验组,按照性别、年龄匹配同一时间段内同等样本量的多发骨折但未合并DIC的患者为对照组.分析骨折数量、吸烟史、高脂血症、多发骨折术后第1天血小板、凝血酶原时间、国际标准化比值、D-二聚体、同型半胱氨酸等,对预测多发骨折术后DIC的价值.结果实验组48例,对照组48例.二元logistic回归分析发现,多发骨折术后第1天血小板、D-二聚体、同型半胱氨酸等是多发骨折术后DIC的危险因素.将上述指标绘制ROC曲线,表明多发骨折术后第1天D-二聚体、同型半胱氨酸是多发骨折术后DIC的独立危险因素.结论多发骨折患者术后第1天D-二聚体、同型半胱氨酸数值较高,需警惕出现DIC可能.

Objective To investigate the risk factors for disseminated intravascular coagulation (DIC) after operation of multiple fractures. Methods Patients with multiple fractures combined with DIC from March 2017 to December 2018 were enrolled as experimental groups. According to the gender and age, patients with multiple fractures with the same sample size in the same time period but without DIC were matched as the control group. Analysis of the number of fractures, smoking history, hyperlipidemia, and platelet, prothrombin time, international normalized ratio, D-dimer, homocysteine on the first day after operation were evaluated for predicting DIC. Results Finally, 48 cases were included in the experimental group and 48 cases in the control group. According to the binary logistic regression analysis, it was found that platelets, D-dimer and homocysteine on the first day after operation were the risk factors for DIC. The above indicators were used to draw ROC curves. It was found that D-dimer and homocysteine on the first day after operation were the independent risk factors for DIC. Conclusion For patients with multiple fractures, if the D-dimer and homocysteine values are higher on the first day after operation, it is necessary to be alert to the possibility of DIC.