下肢不同部位骨折患者D-二聚体与深静脉血栓关系的研究

Study on the Relationship between D-dimer and Deep Vein Thrombosis in Patients with Fractures of Different Sites of Lower Extremities

目的通过检测下肢不同部位骨折患者在术前、术后血浆中D-二聚体水平,探索其与深静脉血栓之间的关系。方法选取常熟市支塘人民医院2019年1月—2022年2月收治的164例下肢骨折患者,按照其是否形成下肢深静脉血栓分观察组(有血栓,35例)与对照组(无血栓,129例),通过D-二聚体检测,并结合彩超,对比两组的深静脉血栓发生率、不同部位骨折的D-二聚体水平。结果髋部、膝部骨折患者D-二聚体水平显著高于踝部骨折患者(P<0.05),髋部骨折及膝部骨折患者深静脉血栓发生率明显高于踝部骨折患者(P<0.05)。对照组患者在接受手术后D-二聚体水平逐渐下降,观察组患者术后1 d、3 d、7 d、15 d D-二聚体水平明显高于对照组(P<0.05)。结论骨折是深静脉血栓发生的独立危险因素,对骨折患者进行血浆D-二聚体检测,有利于及时发现存在的深静脉血栓风险,以便及早采取干预措施,降低临床深静脉血栓发生率。

Objective The aim of this study is to explore the relationship between D-dimer and deep vein thrombosis in patients with fractures of different sites of the lower extremities through level detection of D-dimer before and after operation.Methods A total of 164 patients with lower extremity fractures whom received treatment in our hospital were recruited from January 2019 to February 2022.According to with or without deep vein thrombosis of lower extremities,the patients were divided into observation group(n=35)and control group(n=129).Based on the results of D-dimer detection and color Doppler ultrasound,the incidence of deep vein thrombosis in two groups were compared and the D-dimer level of patients with fractures in different sites were analyzed between and in two groups.Results The levels of D-dimer in patients with hip and knee fractures were significantly higher than that in patients with ankle fractures(P<0.05),and the incidences of deep vein thrombosis in patients with hip and knee fractures were significantly higher than that in patients with ankle fractures(P<0.05).The D-dimer level of patients in the control group decreased gradually after operation,and the D-dimer level of patients in the observation group was significantly higher than that in the control group on the 1st day,3rd day,7th day,and 15th day after operation(P<0.05).Conclusion The fracture site is an independent risk factor for the occurrence of deep vein thrombosis.The detection of plasma D-dimer in fracture patients is helpful to detect the existing risk of deep vein thrombosis in time,thereby taking early intervention measures and reducing the incidence of clinical deep vein thrombosis.