D-二聚体监测预防急性深静脉血栓的意义
发布时间：2018-12-08 10:42
【摘要】：目的 探讨D-二聚体及血栓弹力图(TEG)在预测全髋关节置换术后急性下肢深静脉血栓(DVT)中的意义。方法 纳入2015年12月-2016年5月在该院关节外科行全髋关节置换的患者93例,动态监测置换前及置换后1、3、5、7和12 d的D-二聚体,并定期检测TEG各项指标,置换后12 d行双下肢静脉彩超,根据彩超结果有无血栓形成分为血栓组与对照组。对比两组患者D-二聚体及TEG各项指标的水平。结果 患者术后定期行患侧肢体血管彩超检查,术后1周内行彩超检查未发现血栓形成,术后第12天彩超检查提示11例患者存在小腿肌间静脉血栓,纳入血栓组;其余82例患者未发现血栓,纳入对照组。两组患者在年龄、吸烟史,体重、手术时长及术中失血量比较,差异无统计学意义(P0.05)。血栓组与对照组术前及术后1、3、5、7和12 d D-二聚体水平比较,差异有统计学意义(P0.05),所有患者术后较术前凝血反应时间(R)缩短,血栓最大幅度(MA)升高,伴α角升高。术后第12天血栓组TEG的R时间、凝固时间、a角、MA、凝血块强度值及D-二聚体与对照组比较,差异有统计学意义(P0.05)。结论 提示髋关节置换术后D-二聚体的动态监测及TEG、小腿肌间静脉丛彩超检查有助于早期发现血栓。
[Abstract]:Objective to investigate the significance of D-dimer and thromboelastography (TEG) in predicting acute deep venous thrombosis (DVT) after total hip arthroplasty. Methods from December 2015 to May 2016, 93 patients underwent total hip arthroplasty in our hospital. The D-dimer before and after replacement was monitored dynamically, and the TEG indexes were detected regularly. On the 12th day after replacement, the patients were divided into two groups: thrombus group and control group according to the results of color Doppler ultrasound. The levels of D-dimer and TEG were compared between the two groups. Results Color Doppler ultrasonography was performed regularly in the affected limbs after operation, and no thrombus was found in the first week after operation. On the 12th day after operation, color Doppler ultrasonography showed that 11 patients had intermuscular vein thrombosis in the leg and were included in the thrombus group. The remaining 82 patients without thrombus were included in the control group. There was no significant difference in age, smoking history, body weight, length of operation and blood loss during operation between the two groups (P0.05). The level of D-dimer in the thrombus group was significantly higher than that in the control group (P 0.05). The postoperative coagulation reaction time (R) was shorter and the maximal thrombus (MA) was higher in the thrombus group than in the control group (P 0.05). Accompanied by 伪 -angle elevation. On the 12th day after operation, the R time, coagulation time, a angle, MA, clot intensity and D-dimer in thrombus group were significantly different from those in control group (P0.05). Conclusion dynamic monitoring of D-dimer after hip arthroplasty and color Doppler ultrasound examination of TEG, 's intermuscular venous plexus of lower leg are helpful for early detection of thrombus.
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本文编号：2368213
[Abstract]:Objective to investigate the significance of D-dimer and thromboelastography (TEG) in predicting acute deep venous thrombosis (DVT) after total hip arthroplasty. Methods from December 2015 to May 2016, 93 patients underwent total hip arthroplasty in our hospital. The D-dimer before and after replacement was monitored dynamically, and the TEG indexes were detected regularly. On the 12th day after replacement, the patients were divided into two groups: thrombus group and control group according to the results of color Doppler ultrasound. The levels of D-dimer and TEG were compared between the two groups. Results Color Doppler ultrasonography was performed regularly in the affected limbs after operation, and no thrombus was found in the first week after operation. On the 12th day after operation, color Doppler ultrasonography showed that 11 patients had intermuscular vein thrombosis in the leg and were included in the thrombus group. The remaining 82 patients without thrombus were included in the control group. There was no significant difference in age, smoking history, body weight, length of operation and blood loss during operation between the two groups (P0.05). The level of D-dimer in the thrombus group was significantly higher than that in the control group (P 0.05). The postoperative coagulation reaction time (R) was shorter and the maximal thrombus (MA) was higher in the thrombus group than in the control group (P 0.05). Accompanied by 伪 -angle elevation. On the 12th day after operation, the R time, coagulation time, a angle, MA, clot intensity and D-dimer in thrombus group were significantly different from those in control group (P0.05). Conclusion dynamic monitoring of D-dimer after hip arthroplasty and color Doppler ultrasound examination of TEG, 's intermuscular venous plexus of lower leg are helpful for early detection of thrombus.
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本文编号：2368213
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