老年下肢骨折患者手术前后D-二聚体和血小板参数变化
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摘要
目的:回顾性分析老年下肢骨折患者手术前后D-二聚体(D-D)和血小板参数水平变化并探讨其对患者术后血栓的预测价值。方法:2016-01—2016-12本院收治的102例老年骨折患者,根据是否发生下肢深静脉栓塞(DVT)分为DVT组(n=35)和非DVT组(n=67)。定量检测所有患者手术前后D-D和血小板相关参数[包括血小板数量(PLT)、平均血小板体积(MPV)和血小板分布宽度(PDW)],选择同期体检健康老年人作为对照(对照组,n=35),并比较组间差异。结果:术前,DVT组与非DVT组PLT、MPV和PDW比较,差异无统计学意义(P>0.05);DVT组D-D显著高于非DVT组(P<0.05)。术后,DVT组D-D、PLT、MPV、PDW均显著高于非DVT组(P<0.01)。结论:密切观察老年下肢骨折患者手术后D-D和血小板相关参数水平变化对于术后DVT预测有重要临床价值。
Objective:To analyze changes of D-dimer and platelet parameters before and after surgery in elderly patients with fractures and its predictive value for postoperative thrombosis.Method:2016-01—2016-12 in this hospital,102 patients with senile fractures were divided into deep vein thrombosis(DVT)group(n=35)and nonDVT group(n=67)depending on whether or not venous thromboembolism occurred.D-dimer and platelet-related parameters,including platelet count(PLA)platelet volume(MPV),and platelet distribution width(PDW),before and after surgery in all patients were detected.Results:Before surgery,there was no significant difference in MPV and PDW between DVT group and non-DVT group(P>0.05).D-dimer in DVT group was significantly higher than that in non-DVT group(P<0.05).After operation,D-dimer,PLA,MPV,and PDW in DVT group were significantly higher than those in non-DVT group(P<0.01).Conclusion:Detection of D-dimer and platelet-related parameters in elderly patients with fractures has important clinical predictive value for postoperative DVT.
Objective:To analyze changes of D-dimer and platelet parameters before and after surgery in elderly patients with fractures and its predictive value for postoperative thrombosis.Method:2016-01—2016-12 in this hospital,102 patients with senile fractures were divided into deep vein thrombosis(DVT)group(n=35)and nonDVT group(n=67)depending on whether or not venous thromboembolism occurred.D-dimer and platelet-related parameters,including platelet count(PLA)platelet volume(MPV),and platelet distribution width(PDW),before and after surgery in all patients were detected.Results:Before surgery,there was no significant difference in MPV and PDW between DVT group and non-DVT group(P>0.05).D-dimer in DVT group was significantly higher than that in non-DVT group(P<0.05).After operation,D-dimer,PLA,MPV,and PDW in DVT group were significantly higher than those in non-DVT group(P<0.01).Conclusion:Detection of D-dimer and platelet-related parameters in elderly patients with fractures has important clinical predictive value for postoperative DVT.
引文
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6张雨,卢中原,李林燕,等.下肢静脉曲张患者血小板参数和D-二聚体的变化及意义[J].中医药临床杂志,2016,28(1):86-87.
7李静丹,贾铁钢,张景丹.D-二聚体峰值与下肢单纯闭合性骨折患者深静脉血栓形成的关系[J].贵州医科大学学报,2017,42(1):105-108.
8杨银芳,李燕平.D-二聚体检测在静脉血栓栓塞症诊断中的应用[J].国际检验医学杂志,2014,35(13):1 758-1 760.
9马明静,刘道阔,王庆凯,等.D-二聚体水平在下肢深静脉血栓形成治疗中的监测价值研究[J].中国循证心血管医学杂志,2017,9(1):46-49.
10韩贵宾,张寿,孙薇薇等.44例骨科血小板增高患者的临床分析[J].检验医学与临床,2016,13(1):144-145.
11陈晖.血液病患者血小板MPV、PCT、PDW的检测意义[J].实用全科医学,2006,4(4):479.
12郎春法,方建飞,应群贞,等.平均血小板体积和D-D测定在疑似深静脉血栓患者中的应用[J].放射免疫学杂志,2013,26(2):209-210.
2Menaker J,Stein DM,Scalea TM.Pulmonary embolism after injury:more common than we think[J].J Trauma,2009,67(6):1244-1 249.
3Selby R,Geerts W,Ofosu FA,et al.Hypercoagulability after trauma:hemostatic changes and relationship to venous thromboembolism[J].Thromb Res,2009,124(3):281-287.
4Lazzarin P,Cesaro G,Puggina S,et al.Femoral andhumeral head osteonecrosis in a patient with hypofibrinolysis and hyperhomocysteinemia.A case report and a review of the literature[J].Reumatismo,2004,56(3):202-210.
5Chen F,Xiong JX,Zhou WM.Differences in limb,age and sex of Chinese deep vein thrombosis patients[J].Phlebology,2015,30(4):242-248.
6张雨,卢中原,李林燕,等.下肢静脉曲张患者血小板参数和D-二聚体的变化及意义[J].中医药临床杂志,2016,28(1):86-87.
7李静丹,贾铁钢,张景丹.D-二聚体峰值与下肢单纯闭合性骨折患者深静脉血栓形成的关系[J].贵州医科大学学报,2017,42(1):105-108.
8杨银芳,李燕平.D-二聚体检测在静脉血栓栓塞症诊断中的应用[J].国际检验医学杂志,2014,35(13):1 758-1 760.
9马明静,刘道阔,王庆凯,等.D-二聚体水平在下肢深静脉血栓形成治疗中的监测价值研究[J].中国循证心血管医学杂志,2017,9(1):46-49.
10韩贵宾,张寿,孙薇薇等.44例骨科血小板增高患者的临床分析[J].检验医学与临床,2016,13(1):144-145.
11陈晖.血液病患者血小板MPV、PCT、PDW的检测意义[J].实用全科医学,2006,4(4):479.
12郎春法,方建飞,应群贞,等.平均血小板体积和D-D测定在疑似深静脉血栓患者中的应用[J].放射免疫学杂志,2013,26(2):209-210.