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

摘要

目的：探讨D-二聚体峰值与下肢单纯闭合性骨折患者深静脉血栓的关系。方法：选取下肢单纯闭合性骨折患者122例，入院1周彩色多普勒超声检测有无深静脉血栓形成，并根据结果分为有深静脉血栓组及无深静脉血栓组；比较两组患者年龄、血常规、凝血功能、肝肾功能及是否长期卧床等临床资料，入院后连续检测D-二聚体水平，采用Logistic回归法分析临床因素与深静脉血栓形成的关系，同时分析D-二聚体峰值对深静脉血栓形成的诊断价值。结果：122例下肢单纯闭合性骨折患者深静脉血栓发生率为33.61%（41/122），有深静脉血栓组D-二聚体峰值、长期卧床（﹥7 d）患者所占比例、早期（3 d内）D-二聚体连续性升高患者所占比例高于无深静脉血栓组（ P﹤0.05），Logistic回归分析显示D-二聚体峰值、长期卧床以及早期D-二聚体连续性升高是下肢单纯闭合性骨折患者深静脉血栓形成的危险因素；有深静脉血栓组血浆D-二聚体达到峰值的时间相对较晚，D-二聚体峰值﹥2 mg/L作为界值对下肢单纯闭合性骨折患者深静脉血栓形成的诊断符合率最高，为77.83%。结论：长期卧床、早期D-二聚体连续升高、D-二聚体峰值是下肢单纯闭合性骨折患者深静脉血栓形成的危险因素， D-二聚体峰值大于2 mg/L则提示深静脉血栓形成可能性大。%[ Abstract]Objective:To study the relationship between D-two peak and deep venous thrombosis in patients with single closed fracture of lower extremity. Methods:122 cases of simple closed fracture of lower extremity were selected,and whether deep venous thrombosis happened was examined by color Doppler ultrasound after admission for 1 weeks,according to the results,the patients were divided into two groups. Age,blood routine,coagulation function,liver and kidney function and whether long-term bed were compared,D-dimer level was continuously detected after admission. Logistic regression was used to analyze the relationship between clinical factors and deep venous thrombosis,and the diagnos-tic value of the peak value of D-dimer in patients with deep venous thrombosis was analyzed. Results:deep venous thrombosis incidence of 122 cases of patients with closed fracture of lower extremity was 33. 61%(41/122),in deep vein thrombosis group D-dimer peak,the proportion of patients with long-term bed( ﹥7 d),the proportion of patients with early( within 3 d)continuous D-dimer increase were higher than those in non deep venous thrombosis group( P﹤0 . 05 ). Logistic regression analysis showed that the peak of D-dimer,long-term bed,and the early continuous increase of D-dimer were the risk factors of deep venous thrombosis in patients with closed fracture of lower extremity;the time that D-dimer reached peak in deep vein thrombosis group was relatively late,the coincidence rate of D-dimer peak ﹥2 mg/L as the critical value for the diagnosis of deep vein thrombosis in patients with closed fracture of lower extremity was highest with 77. 83%. Conclusion:The peak of D-dimer,long-term bed,and the early continuous increase of D-dimer are the risk factors of deep venous thrombosis in patients with closed fracture of lower extremity,When the peak value of D-dimer is greater than 2 mg/L,the possibility of deep venous thrombosis is large.