Efficacy of percutaneous mechanical thrombus removal in acute lower extremity deep venous thrombosis

BACKGROUND Acute lower extremity deep venous thrombosis(LEDVT)is a common vascular emergency with significant morbidity risks,including post-thrombotic syndrome(PTS)and pulmonary embolism.Traditional treatments like catheter-directed thrombolysis(CDT)often result in variable success rates and complications.AIM To investigate the therapeutic efficacy of percutaneous mechanical thrombus removal in acute LEDVT.METHODS A retrospective analysis was performed to examine 58 hospitalised patients with acute LEDVT between August 2019 and August 2022.The patients were categorised into the percutaneous mechanical thrombectomy(PMT)group(n=24)and CDT group(n=32).The follow-up,safety and treatment outcomes were compared between the two groups.The main observational indexes were venous patency score,thrombus removal effect,complications,hospitalisation duration and PTS.RESULTS The venous patency score was 9.04±1.40 in the PMT group and 8.81±1.60 in the CDT group,and the thrombus clearance rate was 100%in both groups.The complication rate was 8.33%in the PMT group and 34.84%in the CDT group,and the difference was statistically significant(P<0.05).The average hospitalisation duration was 6.54±2.48 days in the PMT group and 8.14±3.56 days in the CDT group.The incidence of PTS was lower in the PMT group than in the CDT group;however,the difference was not statistically significant(P<0.05).CONCLUSION Compared with CDT,treatment of LEDVT via PMT was associated with a better thrombus clearance rate,clinical therapeutic effect and PTS prevention function,but the difference was not statistically significant.Moreover,PMT was associated with a reduced urokinase dosage,shortened hospitalisation duration and reduced incidence of complications,such as infections and small haemorrhages.These results indicate that PMT has substantial beneficial effects in the treatment of LEDVT.

Clinical Value of Predictive Nursing Intervention on Deep Venous Thrombosis of Lower Extremities after Cesarean Section

[Objectives]To explore the clinical nursing value of predictive nursing intervention in patients with deep venous thrombosis of lower extremities after cesarean section.[Methods]From December 2022 to April 2023,105 pregnant and lying-in women who were hospitalized in the Gynecology Department of Pingquan Hospital and underwent cesarean section and met the inclusion criteria were included as the study objects.According to the medical records,they were divided into observation group(n=52 cases)and control group(n=53 cases).The clinical experimental subjects were divided into two groups.One group was the control group with routine nursing,and the other group was the observation group with predictive nursing intervention.The number of cases of deep venous thrombosis of lower extremities in the two groups was recorded to evaluate the clinical value.[Results]The incidence of deep venous thrombosis of lower extremities in the two groups after cesarean section was compared,and it was suggested that the incidence of the observation group was lower than that of the control group(P<0.05).[Conclusions]Special predictive nursing intervention can greatly reduce the incidence of deep venous thrombosis of lower extremities after cesarean section,improve nursing satisfaction,and improve clinical efficacy,which is worthy of recommendation.

Deep Venous Thrombosis: Commonly Affected Veins in the Lower Limbs

Aim and Objectives: This study aimed to record the commonly affected veins in the lower limbs, to compare the affected sides and gender and to correlate the Doppler findings and stages of deep venous thrombosis (DVT). Materials and Methods: A descriptive retrospective study of 46 already diagnosed cases of lower limb DVT. Results: Out of 46 cases of DVT, 71.74% were females. The majority of patients (93.47%) were affected in unilateral lower limb with significant predominance (65.22%) to affect the left lower limb (p Conclusion: Lower limb deep venous thrombosis affects left lower limb more than right and females more than males. Superficial femoral vein (SFV) and common femoral vein (CFV) are the most common affected veins. Lower limb DVT predominantly present in acute stage with venous distension and absent blood flow.

Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients

Objective：To evaluate Wells, Kahn, St.Andr 6 and Constans scores for the prediction of deep venous thrombosis in Chinese patients. Methods：One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography. Sensitivity, specificity, positive predictive value, negative predictive value and receiver operation curves were calculated for four clinical scores. The difference between areas of the ROC curve for each of the scores was compared with others and reference line. Results：Forty-six of 172 patients had deep venous thrombosis proven by sonography. The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 57.1%, 43.8% and 94.7%, respectively, for Kahn score; 65.2%, 71.4%, 45.5% and 84.9%, respectively, for St.Andr 6 score; 63%, 38.9%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively. Area under ROV curve of Constans score was 0.814, which was similar to that of Wells score, then followed by Kahn score and that of St.Andr 6 score was no difference with the reference line. Conclusion：Based on the results of our study, the sensitivity, negative prediction value and area under ROC curve are larger for Constans score and Wells score in Chinese hospitalized patients than that of Kahn score or St.Andr 6 score. Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

Combined effect of Traditional Chinese Medicine decoction and low-molecular-weight heparin calcium on the postoperative deep venous thrombosis in patients with lower limb fracture

OBJECTIVE: To investigate the combined effect of Traditional Chinese Medicine(TCM) decoction and low-molecular-weight heparin calcium on deep vein thrombosis(DVT) induced by surgery in patients with lower limb fracture.METHODS: Totally 86 hospitalized patients with DVT after surgery of lower limb fracture between September 2012 and January 2015 were recruited and randomly divided into control group and observation group, 43 cases in each group. The patients in the control group were treated with subcutaneous injection of low-molecular-weight heparin calcium, and those in the observation group were additionally given Danshen Injection and TCM decoction. The differences between two groups in occurrence rate, medication time, therapeutic effects,recurrence rate of thrombosis, activated partial thromboplastin time(APTT), and prothrombin time(PT) were compared.RESULTS: The occurrence rate of DVT in observation group(4.65%, 2/43) was lower than that in control group(27.91%,12/43)(P<0.05). The medication time of observation group was(6.15±2.94) d, shorter than(9.76±3.12) d in the control group(P<0.05). In observation group, 2 cases of DVT were cured(2/2); in the control group, 9 cases presented therapeutic effects and the total effective rate was 75.00%(9/12). The improvement of APTT and PT in the observation group was better than that in the control group(P<0.05).CONCLUSION: Integrative TCM decoction plus low-molecularweight heparin calcium is superior to applicaton of low-molecularweight heparin calcium alone in reducing and treating DVT in the postoperative patients with lower limb fracture.

Two-point compression ultrasonography: Enough to rule out lower extremity deep venous thrombosis?

BACKGROUND: Deep venous thrombosis(DVT) is a major cause of morbidity and is a common presenting complaint to the emergency department(ED). Point-of-care two-point compression ultrasonography has evolved as a quick and effective way of diagnosing DVT. The purpose of this study is to validate the prevalence and distribution of venous thrombi isolated to proximal lower extremity veins, other than common femoral and popliteal veins in patients with DVT.METHODS: This is a single-center retrospective study that looked at patients presenting to the ED of a tertiary care hospital between January 2014 and August 2018. The clinical presentation and laboratory and imaging results were obtained using the hospital's electronic medical record.RESULTS: A total of 2,507 patients underwent a lower extremity duplex ultrasound during the study period. Among them, 379(15%) were included in the study. The percentages of isolated thrombi to the femoral vein and deep femoral vein were 7.92% and 0.53%, respectively. When the patients were stratified into the two groups of isolated DVT and two-point compression DVT, there were no statistically significant differences in the laboratory results between both groups. However, immobilized patients and patients with recent surgeries were more likely to have an isolated DVT.CONCLUSIONS: Thrombi isolated to proximal lower extremity veins other than the common femoral and popliteal veins make up 8.45% of DVTs. Given this significant number of missed DVTs, the authors recommend the addition of the femoral and deep femoral veins to the two-point compression exam.

Clinical Application of Percutaneous Transluminal Angioplasty and Stent Implantation in Acute Lower Extremity Deep Venous Thrombosis

Purpose: To analyze the application of percutaneous transluminal angioplasty and stenting in acute deep venous thrombosis of lower extremities. Methods: 70 patients were divided into two groups according to the presence or absence of percutaneous transluminal angioplasty and stenting. Results: The mean circumferential diameter difference between the affected limbs and the healthy limbs and the knees at 15 cm was statistically significant. The cure rate and effective rate of the research group were higher than those of the control group (P<0.05). Conclusion: Percutaneous transluminal angioplasty and stenting are of high value in acute lower extremity deep venous thrombosis.

Discussion on Prevention and Treatment of Lower Extremity Deep Venous Thrombosis in Orthopedic Perioperative Period from Spleen and Stomach Meridians

Deep venous thrombosis of lower extremity is one of the common complications in orthopedic perioperative period.It is caused by many factors,such as peripheral vein dilation,slow blood flow;long-term immobilization,bed rest and so on.On the one hand,it affects the early postoperative functional exercise and functional recovery,on the other hand,it increases the length of hospital stay and economic burden,increases the pain of patients and even endangers their lives.Effective treatment of traditional Chinese medicine combined with western medicine can play a better role in the prevention and treatment of lower extremity deep venous thrombosis.This study expounds the concept of spleen and stomach meridians in the prevention and treatment of lower extremity deep venous thrombosis,and puts forward some opinions on the dialectical treatment and daily conditioning of lower extremity deep venous thrombosis,hoping to provide ideas for the clinical prevention and treatment of lower extremity deep venous thrombosis in traditional Chinese medicine.

Analysis of curative effect of Bingxiao powder on lower limb deep vein thrombosis

Objective:To investigate the therapeutic effect of Bingxiao powder on edema caused by deep venous thrombosis in lower limb thrombosis.Methods:Selected in our hospital from September 2017 to April 2019 of 122 patients with lower limb deep vein thrombosis caused by edema.The patients were divided into two groups:Bingxio powder(61 cases)and magnesium sulfate(61 cases),the circumference difference of lower leg and thigh,the integral of edema and pain,the effective rate and the satisfaction rate of curative effect were compared between the two groups of patients with edema caused by thrombosis of lower limb.Results:in the observation group,the peripheral diameter difference of calf(1.08±0.21)cm,the peripheral diameter difference of thigh(1.76±0.28),the edema score(1.09±0.22)and the pain score(1.34±0.25)were all lower than those of the control group(P<0.05).The effective rate(95.08%)and satisfaction rate(96.72%)of the observation group were higher than those of the control group(P<0.05).Conclusion:Bingxiao powder can reduce the edema symptoms and pain symptoms of patients with edema caused by deep venous thrombosis of lower limbs,and reduce the circumference difference of the lower leg and thigh,with significant clinical effect.

Prevention and Treatment of Deep Vein Thrombosis of the Lower Limbs in Patients with Complications after Orthopedic Trauma Surgery

Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.

Analysis thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis in the lower extremities

Objective: To explore the effect of thrombolysis with anticoagulation treatment for early stage of deep vein thrombosis of lower extremity. Methods: The clinical data of 106 patients at the early stage of deep vein thrombosis (DVT) in the lower extremities treated by thrombolysis with anticoagulation and dispersion drugs were analyzed retrospectively. Results: The thrombolytic effect was significant. After treatment, the deep veins were recanalized without regurgitation in 75.3% of the patients. The total effective rate was 100%. Only three patients had hemorrhagic complication, but none of the patients died. Conclusion: Thrombolysis with anticoagulation treatment is an effective and safe method for DVT at the early stage.

Predictive Value of Systemic Immune Inflammation Index, Aggregate Index of Systemic Inflammation, and Systemic Inflammation Response Index in Lower Extremity Deep Venous Thrombosis Following Severe Trauma

Objective Venous thromboembolism is a highly prevalent condition after polytrauma,and recognized as an important factor contributing to poor prognosis.The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis(LEDVT)in a severely traumatized population and to evaluate their predictive value for LEDVT.Methods This was a retrospective,single-center observational study.All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024.Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury,patients who developed LEDVT were enrolled in the LEDVT group,and those who did not develop LEDVT were enrolled in the NLEDVT group.Demographic,clinical,and laboratory data were collected upon admission.Multivariable logistic regression analysis was performed to identify risk factors for LEDVT.Receiver operating characteristic(ROC)curve was used to evaluate the overall fit of the final model.Results There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age,Aggregate Index of Systemic Inflammation(AISI),Systemic Inflammation Response Index(SIRI),ICU length of stay,and albumin were identified as independent risk factors for LEDVT(all P<0.05).The area under their ROC curves were 0.604,0.657,0.694,0.668,and 0.405,respectively.Combined model for early clinical prediction of LEDVT in severely traumatized patients by age,SIRI,AISI,and albumin resulted in an area under the ROC curve of 0.805(95%CI:0.73-0.88,SE=0.037).Conclusion The combination of age,SIRI,AISI,and albumin has a predictive value for LEDVT in severely traumatized patients.

补阳还五汤加减预防MIS-TLIF术后下肢静脉血栓临床研究

目的探究补阳还五汤加减预防微创经椎间孔入路腰椎椎间融合手术(MIS-TLIF)术后下肢静脉血栓的效果。方法病例选取符合纳入标准及排除标准的景德镇市中医医院骨伤科2021年12月—2023年11月间行MIS-TLIF手术患者60例,根据数字随机分组法分成治疗组、对照组,分别为30例。治疗组运用补阳还五汤加减结合那屈肝素钙口服进行预防;对照组通过那屈肝素钙进行预防;通过观察术后13 d、21 d日本骨科协会腰痛评分表(JOA评分)、D-2聚体、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)结果。评价补阳还五汤加减的临床疗效。结果两组患者术后13 dAPTT、PT、D-2聚体、JOA评分差异无统计学意义(P>0.05)。两组患者术后21 dAPTT、PT、D-2聚体、JOA评分差异有统计学意义(P<0.05),治疗组APTT、PT、JOA评分大于对照组,治疗组D-2聚体小于对照组。结论补阳还五汤加减通过改变机体抗凝机制,抑制血小板聚集,从而起到预防下肢静脉血栓的作用,同时恢复腰椎功能。

血清NETs、FIB、miR-374a-5p水平与膝关节置换术后下肢深静脉血栓形成的相关性分析

目的探讨膝关节置换术后血清中性粒细胞胞外陷阱(NETs)、纤维蛋白原(FIB)、微小RNA-374a-5p(miR-374a-5p)水平变化,并分析其与术后下肢深静脉血栓形成(DVT)相关性及其预测效能。方法选取2020年9月至2023年5月于郑州阳城医院行膝关节置换术患者108例为研究对象,依据术后7 d是否发生下肢DVT分为DVT组32例、非DVT组76例。对比分析两组临床资料及术前、术后1 d、术后3 d血清NETs、FIB、miR-374a-5p水平。采用Pearson法分析术前血清NETs、FIB、miR-374a-5p水平与静脉血栓栓塞症风险评估量表(Caprini)评分相关性。采用多因素Logistic回归分析术后下肢DVT发生的影响因素。采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评价血清NETs、FIB、miR-374a-5p水平对术后下肢DVT发生的预测价值。结果DVT组术后1 d、3 d血清NETs、FIB、miR-374a-5p水平高于非DVT组(P<0.05);术前血清NETs、FIB、miR-374a-5p水平与Caprini评分呈正相关(P<0.05);Caprini评分与术后3 d血清NETs、FIB、miR-374a-5p水平升高为术后下肢DVT发生的独立危险因素(P<0.05);术后3 d血清NETs、FIB、miR-374a-5p水平联合预测术后下肢DVT发生的AUC大于单项指标预测(P<0.05)。结论膝关节置换术后DVT者血清NETs、FIB、miR-374a-5p水平升高,联合检测其水平对术后下肢DVT发生具有一定预测价值。

基于CCD-RSM联用D-最优混料设计优化抗下肢静脉血栓颗粒制剂工艺的研究

目的 采用星点设计-效应面法(CCD-RSM)联用D-最优混料设计,优化抗下肢静脉血栓颗粒的制剂工艺。方法 以溶媒用量、煎煮时间为主要考察因素,以有效成分丹酚酸B和多糖含量及干膏收率的总评归一值(OD)为评价指标,采用CCD-RSM确定最佳提取工艺;以颗粒吸湿率为评价指标,结合溶化性、成型率、休止角等,利用D-最优混料设计优选最佳成型工艺。结果 最佳提取工艺:采用8倍量水提取2次,每次100 min。成型工艺为浸膏与辅料比例1:2,辅料间比例为可溶性淀粉:糊精:蔗糖=0.452:0.518:0.030。结论 优选的制剂工艺条件稳定、可行,可为抗下肢静脉血栓颗粒的生产提供依据。

柚皮素抑制cGAS-STING通路活化对大鼠下肢深静脉血栓形成的影响

【目的】探讨柚皮素抗大鼠下肢深静脉血栓形成机制。【方法】将60只大鼠随机分为6组,即假手术组,模型组,柚皮素低、中、高剂量组和柚皮素高剂量+STING激动剂2.5己酮可可碱(DMXAA)组,每组10只。检测各组大鼠凝血指标[D-二聚体(D-dimer)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)],炎症指标[白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]及氧化应激指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)];苏木素-伊红(HE)染色法检测静脉血栓形成;检测血栓湿质量和干质量;透射电镜检测静脉血栓超微结构;Western Blot法检测静脉血栓组织中环鸟苷酸-腺苷酸合成酶(c GAS)、干扰素基因刺激因子(STING)蛋白表达。【结果】(1)与假手术组比较,模型组大鼠D-dimer水平,IL-1β、IL-6、TNF-α水平,MDA含量,血栓湿质量和干质量增加,TT、APTT、PT,SOD活性和GSH-Px活性降低(均P<0.05);与模型组比较,柚皮素低、中、高剂量组大鼠D-dimer水平,IL-1β、IL-6、TNF-α水平,MDA含量,血栓湿质量和干质量降低,TT、APTT、PT,SOD活性和GSH-Px活性增加(均P<0.05),且呈剂量依赖性;与柚皮素高剂量组比较,柚皮素高剂量+DMXAA组大鼠D-dimer水平,IL-1β、IL-6、TNF-α水平,MDA含量,血栓湿质量和干质量升高,TT、APTT、PT,SOD活性和GSH-Px活性降低(均P<0.05)。(2)与假手术组比较,模型组大鼠静脉血栓组织中cGAS、STING蛋白表达水平升高(P<0.05);与模型组比较,柚皮素低、中、高剂量组大鼠静脉血栓组织中cGAS、STING蛋白表达水平均显著降低(P<0.05);柚皮素高剂量+DMXAA组大鼠cGAS、STING蛋白表达水平显著高于柚皮素高剂量组(P<0.05)。【结论】柚皮素可通过抑制cGAS/STING信号通路活化,抑制炎症、氧化应激反应,从而缓解下肢深静脉血栓形成。

AcoStream血栓清除系统联合导管接触性溶栓治疗下肢深静脉血栓形成合并髂静脉压迫综合征的疗效观察

目的观察AcoStream血栓清除系统联合导管接触性溶栓(CDT)治疗下肢深静脉血栓形成(LDVT)合并髂静脉压迫综合征(IVCS)的疗效。方法回顾性分析2020年6月至2022年12月商丘市第一人民医院收治的71例LDVT合并IVCS患者的临床资料。根据治疗方案不同将其分为观察组(接受AcoStream血栓清除系统联合CDT治疗,29例)和对照组(接受CDT治疗,42例)。比较两组植入支架情况、手术前后血红蛋白(Hb)变化、尿激酶用量、住院时间、D-二聚体达峰时间、血栓清除率、大腿周径差、小腿周径差和Villalta评分等。结果观察组尿激酶用量少于对照组,手术前后Hb变化值大于对照组,住院时间、D-二聚体达峰时间短于对照组,差异有统计学意义(P<0.05)。观察组血栓溶解等级情况优于对照组,血栓清除率高于对照组,Villalta评分低于对照组,差异有统计学意义(P<0.05)。两组术后6个月大腿周径差、小腿周径差均较术前显著减小(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论AcoStream血栓清除系统联合CDT治疗LDVT合并IVCS效果确切,出血风险更低,患者症状缓解明显。

Choosing ankle tourniquets in foot and ankle surgery: Beyond postoperative pain considerations

This editorial critically explores the use of ankle vs thigh tourniquets in foot and ankle surgery based on a recent study that found no significant difference in postoperative pain between the two placement techniques.Despite these findings,we argue for the preferential use of ankle tourniquets,highlighting their potential benefits in reducing venous blood stasis and minimizing soft tissue injury.This approach underscores the importance of considering long-term patient outcomes and vascular health beyond immediate postoperative pain.By integrating study findings with broader clinical considerations,we hereby advocate for a nuanced approach to tourniquet use that prioritizes patient safety and long-term recovery in conjunction with immediate postoperative pain.

血清NETs、sCD40L水平对下肢骨折患儿术后发生深静脉血栓的预测价值

目的探究血清中性粒细胞胞外陷阱(NETs)、可溶性CD40配体(sCD40L)水平对下肢骨折患儿术后发生深静脉血栓的预测价值。方法回顾性选取2022年4月至2023年4月深圳平乐骨伤科医院收治的85例下肢骨折患儿为研究对象,均接受下肢静脉造影检查。根据患儿有无深静脉血栓分组:血栓组(n=22)和正常组(n=63)。比较组间术前及术后1 d的血清NETs、sCD40L水平,并对组间临床资料(性别、年龄、体重指数、高血压、糖尿病、受伤类型、受伤至入院时间、术中失血量、手术时间、卧床时间)进行比较;采用多因素Logistics回归分析影响患儿术后发生深静脉血栓的因素;采用受试者操作特征(ROC)曲线评估卧床时间、NETs变化值及sCD40L变化值对患儿术后深静脉血栓发生的预测价值。结果术后1 d,两组的血清NETs、sCD40L水平均较术前升高,且血栓组分别为0.66±0.11、(302.41±42.02)ng/L,均高于正常组[0.51±0.05、(112.20±23.02)ng/L],差异均有统计学意义(P<0.05);血栓组术前及术后1 d的NETs、sCD40L水平差值为0.44±0.05、(196.85±21.02)ng/L,均高于正常组[0.30±0.04、(14.05±3.11)ng/L],差异均有统计学意义(P<0.05)。两组在性别构成比、年龄、体重指数、高血压、糖尿病、受伤类型、受伤至入院时间、术中失血量、手术时间方面比较,差异均无统计学意义(P>0.05);血栓组的卧床时间长于正常组,差异有统计学意义(P<0.05)。经多因素Logistics回归分析结果可知,卧床时间、NETs变化值及sCD40L变化值均是影响患儿术后发生深静脉血栓发生的因素(P<0.05)。卧床时间、NETs变化值及sCD40L变化值预测患儿术后深静脉血栓的曲线下面积值分别为0.801、0.850、0.825,具有较高预测价值。结论血清NETs和sCD40L水平在下肢骨折术后发生深静脉血栓患儿中显著升高,其在预测下肢骨折患儿术后深静脉血栓方面具有较高的价值。

血小板聚集率、ET-1、sEPCR对患者术后下肢深静脉血栓形成的预测效能

目的探讨血小板聚集率、内皮素-1(ET-1)、可溶性内皮细胞蛋白C受体(sEPCR)对患者术后下肢深静脉血栓(DVT)形成的预测效能。方法回顾性选取2019年6月至2023年3月许昌市人民医院收治的250例骨科手术患者作为研究对象,以术后第7天下肢静脉彩超阳性报告术后并发DVT作为判断依据,将患者分为DVT组77例和非DVT组173例。比较两组患者术前1 d、术后1 d、术后3 d的血小板聚集率、ET-1、sEPCR水平,采用Spearman相关系数分析各指标术后水平与术后发生DVT的相关性,绘制受试者工作特征曲线(ROC)评价各指标联合检测对术后患者发生DVT的预测价值,并分析各指标不同水平患者术后发生DVT的危险度。结果术后1 d、3 d,DVT组患者的血小板聚集率、ET-1、sEPCR水平[(67.41±5.02)%、(73.46±6.23)ng/mL、(159.34±13.91)ng/L,(61.79±4.85)%、(68.17±5.31)ng/mL、(147.39±12.46)ng/L]明显高于非DVT组[(49.25±4.87)%、(55.28±5.36)ng/mL、(115.29±12.28)ng/L,(40.02±4.17)%、(46.15±4.29)ng/mL、(90.36±11.17)ng/L],差异均有统计学意义(P<0.05);经Speraman相关系数分析结果显示,术后1 d、3 d血小板聚集率(r=0.682、0.711)、ET-1(r=0.653、0.691)、sEPCR(r=0.535、0.728)与术后发生DVT均呈正相关(P<0.05);经ROC分析结果显示,术后1 d、3 d,血小板聚集率、ET-1、sEPCR水平联合预测术后发生DVT的AUC分别为0.898(95%CI:0.854~0.933)、0.928(95%CI:0.889~0.957);经危险度分析结果显示,术后1 d、3 d血小板聚集率、ET-1、sEPCR高水平患者术后发生DVT的危险度分别是低水平的2.181倍、2.463倍、3.073倍和3.058倍、3.611倍、4.247倍(P<0.05)。结论血小板聚集率、ET-1、sEPCR水平与术后DVT发生呈正相关,三者联合检测对术后是否发生DVT有预测价值,可作为临床预测骨科术后发生DVT的有效指标。