D-二聚体联合血栓弹力图对老年下肢骨折深静脉血栓的评估价值分析

Analylsis on Evaluation Value of D-Dimer Combined with Thromboelastometry for Deep Vein Thrombosis in Elderly Patients with Lower Extremity Fractures

目的:探讨分析D-二聚体(D-D)联合血栓弹力图对老年下肢骨折患者深静脉血栓(DVT)的评估价值。方法:选取2020年1月-2021年7月张家川县第一人民医院收治的102例老年下肢骨折患者为研究对象,根据有无DVT形成分为非DVT组(60例)及DVT组(42例)。两组均行血栓弹力图、D-D及DVT检测,采用多因素logistic回归分析老年下肢骨折患者DVT的影响因素,采用受试者工作特征曲线评估D-D联合血栓弹力图对患者深静脉血栓的评估价值。结果:DVT组骨折至住院时间>24 h、有高血压史、骨质疏松比例高于非DVT组,心血管系统疾病史比例低于非DVT组,差异有统计学意义(P<0.05);DVT组D-D水平高于非DVT组,血栓弹力图R值、K值小于非DVT组,α角、MA值大于非DVT组,差异有统计学意义(P<0.05);高血压史、骨质疏松、D-D水平、血栓弹力图R值、K值、α角、MA值均是老年下肢骨折形成深静脉血栓的影响因素,差异有统计学意义(P<0.05);D-D联合血栓弹力图的敏感度和特异度分别为85.45%、81.46%。结论:D-二聚体联合血栓弹力图可用于评估老年下肢骨折患者深静脉血栓形成,有良好的预测价值。

Objective:To explore and analyze the value of D-dimer(D-D)combined with thromboelastometry in evaluating deep vein thrombosis(DVT)in elderly patients with lower extremity fractures.Methods:A total of 102 elderly patients with lower extremity fractures admitted to the First People's Hospital of Zhangjiachuan County from January 2020 to July 2021 were selected as the study subjects,and they were divided into non-DVT group(60 cases)and DVT group(42 cases)according to the presence or absence of DVT.Thromboelastometry,D-D and DVT were detected in the two groups,and multivariate logistic regression was used to analyze the influencing factors of DVT in elderly patients with lower extremity fractures.The receiver operating characteristic curve was used to evaluate the evaluation value of D-D combined with thromboelastometry in patients with DVT.Results:The time from fracture to hospitalization for>24 h,the history of hypertension and osteoporosis in the DVT group were higher than those in the non-DVT group,and the proportion of cardiovascular system history was lower than that in the non-DVT group,and the difference was statistically significant(P<0.05).The DVT group had higher D-D levels than the non-DVT group,the R value and K value of thromboelastometry were lower than those of the non-DVT group,theαangle and MA value were higher than those of the non-DVT group,and the difference was statistically significant(P<0.05);the history of hypertension,osteoporosis,D-D level,thromboelastometry R value,K value,αangle and MA value were the influencing factors of DVT in elderly patients with lower extremity fractures,and the difference was statistically significant(P<0.05);The sensitivity and specificity of D-D+thromboelastometry were 85.45%and 81.46%,respectively.Conclusion:D-dimer combined with thromboelastometry can be used to evaluate DVT in elderly patients with lower extremity fractures,and has a good predictive value.