Wells评分及D-二聚体测定在高龄髋部骨折患者围术期下肢深静脉血栓预测中的应用价值
|
摘要
目的探讨Wells评分及D-二聚体测定在高龄髋部骨折患者围术期下肢深静脉血栓(DVT)预测中的应用价值。方法回顾性分析2016年1月～2017年7月我院收治的58例高龄髋部骨折患者的临床资料,按照是否发生DVT分为未发生组(36例)与发生组(22例),两组均进行Wells评分及D-二聚体测定。比较两组患者血清中D-二聚体水平以及Wells评分。结果发生组Wells评分>1分的阳性率为86.4%,高于未发生组的5.6%,差异有统计学意义(P<0.05);发生组患者血清中的D-二聚体阴性率为0.9%,低于未发生组的91.7%,差异有统计学意义(P<0.05)。结论高龄髋部骨折患者围术期Wells评分及D-二聚体水平可用于下肢DVT临床诊断。
Objective To explore the application value of Wells score and D-dimer in the prediction of perioperative deep venous thrombosis(DVT) of lower limbs in elderly patients with hip fracture.Methods A retrospective analysis was made on 58 elderly patients with hip fracture treated in our hospital from January 2016 to July 2017,they were divided into non-occurrence group(36 cases) and occurrence group(22 cases) according to whether DVT of lower extremities occurred or not,wells score and D-dimer were measured in both groups.Serum D-dimer levels and Wells scores were compared between the two groups.Results The positive rate of Wells score>1 in the occurrence group was86.4%,which was higher than 5.6% in the non-occurrence group,the difference was statistically significant(P<0.05).The negative rate of D-dimer was 0.9% in the non-occurrence group,which was lower than 91.7% in the non-occurrence group,the difference was statistically significant(P<0.05).Conclusion Perioperative Wells score,D-dimer and lower limbs of elderly patients with hip fracture can be used for DVT clinical diagnosis.
Objective To explore the application value of Wells score and D-dimer in the prediction of perioperative deep venous thrombosis(DVT) of lower limbs in elderly patients with hip fracture.Methods A retrospective analysis was made on 58 elderly patients with hip fracture treated in our hospital from January 2016 to July 2017,they were divided into non-occurrence group(36 cases) and occurrence group(22 cases) according to whether DVT of lower extremities occurred or not,wells score and D-dimer were measured in both groups.Serum D-dimer levels and Wells scores were compared between the two groups.Results The positive rate of Wells score>1 in the occurrence group was86.4%,which was higher than 5.6% in the non-occurrence group,the difference was statistically significant(P<0.05).The negative rate of D-dimer was 0.9% in the non-occurrence group,which was lower than 91.7% in the non-occurrence group,the difference was statistically significant(P<0.05).Conclusion Perioperative Wells score,D-dimer and lower limbs of elderly patients with hip fracture can be used for DVT clinical diagnosis.
引文
[1]冯明利,沈惠良.卒中后偏瘫的老年髋部骨折患者术后一年内死亡相关因素分析[J].中华创伤骨科杂志,2012,14(2):93-97.
[2]曹春风,邱皓,王群波,等.Wells评分联合D-二聚体排除下肢深静脉血栓形成的应用价值研究[J].中国全科医学,2016,19(21):2581-2584.
[3]刘华,关韶峰,倪幼方,等.依诺肝素和普通肝素对不稳定心绞痛及非ST段抬高心肌梗死患者外源性凝血系统和血小板活性的影响[J].上海交通大学学报医学版,2015,35(4):559-567.
[4]傅一牧,李冬冬,荆尧.血小板计数与血红蛋白比值和血糖变化对合并颅脑创伤的多发伤患者下肢深静脉血栓形成的预测价值[J].上海医学,2017,40(1):660-663.
[5]王进,郑欣,张星晨,等.骨科患者临床重要性静脉血栓栓塞症发生的描述性分析[J].中国矫形外科杂志,2018,26(8):698-702.
[6]叶兆莲,张娇,莫莉萍,等.高龄多发骨折患者术后长期卧床并发深静脉血栓的原因分析[J].重庆医学,2018,47(1):101-103.
[7]冯玉倩,张少韶,余淼.下肢深静脉血栓合并肺栓塞的危险因素分析[J].华中科技大学学报(医学版),2016,45(3):319-323.
[8]田锦林,王海峰,屈尔青.下肢深静脉血栓患者非高危肺栓塞危险的多因素分析[J].中国临床医学影像杂志,2015,26(10):692-695.
[9]毛亚锦.彩色多普勒超声检查在诊断下肢深静脉血栓中的应用[J].重庆医学,2015,44(17):2433-2435.
[10]张蕴鑫,刘建龙,贾伟.P-选择素、溶酶体颗粒糖蛋白、血小板活化因子和血浆D-二聚体水平与下肢深静脉血栓形成的关系[J].中国老年学杂志,2017,37(5):1221-1223.
[11]赵银凯,杨波,冯淼淼.术前血常规、凝血指标对神经外科手术患者术后DVT的预测效能[J].2017,57(11):52-54.
[12]丁萌,张青云,景阳.D-二聚体和纤维蛋白原联合检测在下肢深静脉血栓诊断中的应用价值[J].第三军医大学学报,2016,38(16):1885-1888.
[13]张宗祥,张鸿坤,金弢.老年下肢深静脉血栓形成患者尿激酶联合低分子肝素钠治疗前后血浆D-二聚体的表达水平及意义[J].中国老年学杂志,2018,38(8):1883-1884.
[14]曹春风,邱皓,王群波.Wells评分联合D-二聚体排除下肢深静脉血栓形成的应用价值研究[J].中国全科医学,2016,19(21):2581-2584.
[15]孙少君,王晓明.Wells评分联合D-二聚体预测下肢深静脉血栓的价值[J].实用医学杂志,2016,32(1):98-101.
[2]曹春风,邱皓,王群波,等.Wells评分联合D-二聚体排除下肢深静脉血栓形成的应用价值研究[J].中国全科医学,2016,19(21):2581-2584.
[3]刘华,关韶峰,倪幼方,等.依诺肝素和普通肝素对不稳定心绞痛及非ST段抬高心肌梗死患者外源性凝血系统和血小板活性的影响[J].上海交通大学学报医学版,2015,35(4):559-567.
[4]傅一牧,李冬冬,荆尧.血小板计数与血红蛋白比值和血糖变化对合并颅脑创伤的多发伤患者下肢深静脉血栓形成的预测价值[J].上海医学,2017,40(1):660-663.
[5]王进,郑欣,张星晨,等.骨科患者临床重要性静脉血栓栓塞症发生的描述性分析[J].中国矫形外科杂志,2018,26(8):698-702.
[6]叶兆莲,张娇,莫莉萍,等.高龄多发骨折患者术后长期卧床并发深静脉血栓的原因分析[J].重庆医学,2018,47(1):101-103.
[7]冯玉倩,张少韶,余淼.下肢深静脉血栓合并肺栓塞的危险因素分析[J].华中科技大学学报(医学版),2016,45(3):319-323.
[8]田锦林,王海峰,屈尔青.下肢深静脉血栓患者非高危肺栓塞危险的多因素分析[J].中国临床医学影像杂志,2015,26(10):692-695.
[9]毛亚锦.彩色多普勒超声检查在诊断下肢深静脉血栓中的应用[J].重庆医学,2015,44(17):2433-2435.
[10]张蕴鑫,刘建龙,贾伟.P-选择素、溶酶体颗粒糖蛋白、血小板活化因子和血浆D-二聚体水平与下肢深静脉血栓形成的关系[J].中国老年学杂志,2017,37(5):1221-1223.
[11]赵银凯,杨波,冯淼淼.术前血常规、凝血指标对神经外科手术患者术后DVT的预测效能[J].2017,57(11):52-54.
[12]丁萌,张青云,景阳.D-二聚体和纤维蛋白原联合检测在下肢深静脉血栓诊断中的应用价值[J].第三军医大学学报,2016,38(16):1885-1888.
[13]张宗祥,张鸿坤,金弢.老年下肢深静脉血栓形成患者尿激酶联合低分子肝素钠治疗前后血浆D-二聚体的表达水平及意义[J].中国老年学杂志,2018,38(8):1883-1884.
[14]曹春风,邱皓,王群波.Wells评分联合D-二聚体排除下肢深静脉血栓形成的应用价值研究[J].中国全科医学,2016,19(21):2581-2584.
[15]孙少君,王晓明.Wells评分联合D-二聚体预测下肢深静脉血栓的价值[J].实用医学杂志,2016,32(1):98-101.