目的：探讨Wells评分联合D‐二聚体检测在骨创伤致深静脉血栓形成中的应用实效性，为临床提供参考。方法选择2012年1月至2014年7月收治的100例骨创伤患者作为观察组，其中20例深静脉血栓（DV T ）患者作为DV T组；同时选取同期健康者40例作为对照组，分别检测3组研究对象的D‐二聚体水平。结果 DV T组与对照组患者的D‐二聚体水平相比，差异有统计学意义（ t＝15．821，P＜0．05）。多发骨折组、下肢骨折组、骨盆骨折组患者D‐二聚体阳性率均明显高于上肢骨折组，差异均有统计学意义（均 P＜0．05）。若Wells评分低于2分，且D‐二聚体为阴性，基本排除DV T。若Wells评分高于或等于2分，D‐二聚体为阳性，基本判断为DV T。结论D‐二聚体的检测对创伤性骨折致DVT的治疗能够发挥有效的临床价值，尤其是能够对DVT进行排除，是DVT无创伤检查的首选。%Objective To investigate the application effectiveness of Well scores combined with D‐dimer detec‐tion in deep vein thrombosis(DVT) caused by bone trauma in order to provide reference for clinic .Methods 100 pa‐tients with bone trauma in our hospital from January 2012 to July 2014 were selected as the observation group ,among them 20 cases were DVT(DVT group) ,while contemporaneous 40 individuals undergoing the healthy physical exami‐nation were selected as the control group .The D‐dimer level was detected in the three groups .Results The D‐dimer level had statistical difference between the DVT group and the non‐DVT control group(t=15 .821 ,P<0 .05) .The D‐dimer levels in the multiple fractures ,lower limb fractures and pelvic fractures groups were significantly higher than that in the upper limb fracture group ,the differences were statistically significant(P<0 .05) .If the Wells score was less than 2 points ,moreover D‐dimer was negative ,the DVT disease was basically ruled out .If the Wells score was not less than 2 points ,moreover D‐dimer was positive ,the DVT disease was basically judged .Conclusion D‐dimer testing could play the effective clinical value for the treatment of traumatic fracture caused DVT ,especially DVT can be ruled out ,which is the first choice for non‐invasive examination of DVT .
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