Wells评分联合D-二聚体预测下肢深静脉血栓的价值

发布时间：2018-01-22 17:54

  本文关键词： 深静脉血栓 D-二聚体 骨折 Wells评分　出处：《实用医学杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的:回顾分析Wells评分联合D-二聚体预测下肢深静脉血栓(DVT)形成的价值。方法:随机选取2013年1月至2015年1月入本院手外科、骨科治疗的骨折术后患者405例,根据多普勒超声结果将其分为DVT组(n=20)和非血栓组(n=385),另选同期接受体检的40例健康者作为对照组。对疑似DVT的53例患者分别以Wells评分、D-二聚体测定以及两者联合诊断骨折患者术后并发DVT的风险。结果:DVT组D-二聚体值明显高于非血栓组与健康对照组,差异有统计学意义(P0.01):ROC曲线分析显示D-二聚体诊断骨折患者术后并发DVT的最佳临界值为0.575 mg/L,诊断敏感度为90%、特异度为64%,曲线下面积为0.840,P=0.000:根据Wells评分、D-二聚体以及两者联合对骨折合并DVT诊断的灵敏度分别为80.00%、90.00%、90.00%:特异度分别为75.76%、69.70%、87.88%:准确度分别为83.02%、77.36%、88.68%:阳性预测值分别为66.67%、64.29%、81.82%:阴性预测值分别为86.21%、92.00%、93.55%:阳性似然比分别为3.30、2.97、7.43:阴性似然比分别为0.26、0.14、0.11。结论:Wells评分联合血浆D-二聚体检测可以预测骨折患者术后并发下肢DVT的风险,为患者减少不必要的痛苦和检查费用。
[Abstract]:Objective: retrospective analysis of Wells score combined with two D- dimer prediction of lower extremity deep venous thrombosis (DVT) formation value. Methods: randomly selected from January 2013 to 2015 1 month of hand surgery in our hospital, 405 patients were treated in the Department of orthopedics after fracture, according to the Doppler ultrasound were divided into DVT group (n=20) and non thrombus group (n=385), 40 healthy subjects were selected as control group. The medical examination of 53 cases of suspected DVT patients with Wells score, D- two were tested and their combined diagnosis risk associated with DVT fracture patients after operation. Results: in group DVT, two D- dimer value was significantly higher than that of the control group of non thrombus group and health, the difference was statistically significant (P0.01): ROC curve analysis showed that two D- dimer in diagnosis of fracture patients complicated with DVT optimal threshold was 0.575 mg/L, the diagnostic sensitivity was 90%, specificity was 64%, the area under the curve was 0.840 P=0.000:, according to the Wells score, D- two poly The body as well as the combination of fracture with DVT diagnostic sensitivity were 80%, 90%, 90%, specificity was 75.76%, 69.70%, 87.88% respectively, the accuracy was 83.02%, 77.36%, 88.68%, the positive predictive value were 66.67%, 64.29%, 81.82%: the negative predictive value were 86.21%, 92%, 93.55%: positive likelihood ratio were 3.30,2.97,7.43: negative likelihood ratio was 0.26,0.14,0.11. conclusion: Wells score combined with the serum D- two dimer detection can predict the risk of lower extremity DVT fracture patients, for patients to reduce unnecessary pain and examination fees.

【作者单位】： 苏州大学附属无锡九院检验科;
【分类号】：R619;R446.11
【正文快照】： 骨折患者术后由于血管内膜损伤、血液流动瘀滞、炎性介质释放,其血液常处于高凝状态,如处理不当,很容易诱发下肢深静脉血栓(deep veinthrombosis,DVT)[1],故许多学者对其研究高度重视[2-3]。目前有多种方法可以辅助医生诊断DVT,包括Wells评分、血浆D-二聚体检测、彩色多普勒超，

本文编号：1455352