摘要
目的探讨D-二聚体(D-D)检测在不同分娩方式产妇深静脉血栓(DVT)形成中的诊断价值。方法收集2020年12月至2021年12月河西学院附属张掖人民医院收治的84例产妇的临床资料,根据分娩方式的不同将其分为剖宫产组(n=31)和顺产组(n=53)。剖宫产组产妇在腰硬联合麻醉下行剖宫产手术,采用下腹部横行手术切口;顺产组产妇采用无痛分娩方式。检测入院时及分娩后3 h、48 h、96 h血浆中D-D水平,结合彩色多普勒超声检查结果分析D-D检测对不同分娩方式产妇DVT形成的诊断价值。结果分娩后3 h,经D-D检测后,剖宫产组产妇DVT的形成率高于顺产组产妇,差异有统计学意义(P<0.05);分娩后48 h、96 h,两组产妇DVT的形成率比较,差异均无统计学意义(P>0.05)。剖宫产组产妇分娩后3 h、48 h、96 h及顺产组产妇分娩后3 h、48 h,D-D水平检测和彩色多普勒超声检查对DVT形成的评估结果一致。顺产组产妇分娩后96 h,彩色多普勒超声检查出3例DVT形成患者,D-D水平检测出4例DVT形成患者,其中1例为假阳性病例。剖宫产组产妇的血浆D-D水平诊断DVT形成的曲线下面积(AUC)为0.574(95%CI:0.545~0.598,P=0.001),最佳临界值为1684μg/L时,对应的灵敏度和特异度分别为0.744、0.378。顺产组产妇的血浆D-D水平诊断DVT形成的AUC为0.614(95%CI:0.567~0.660,P<0.01),最佳临界值为1799μg/L时,对应的灵敏度和特异度分别为0.587、0.714。结论D-D检测快捷、经济,灵敏度和特异度较高,可作为产妇DVT形成的诊断指标,具有一定的临床推广价值。
Objective To investigate the diagnostic value of D-dimer(D-D)in deep vein thrombosis(DVT)of puerpera with different delivery modes.Method Clinical data of 84 puerpera who delivered in Zhang Ye People's Hospital Affiliated to Hexi University from December 2020 to December 2021 were collected.According to the different delivery methods,the puerpara were divided into caesarean section group(n=31)and natural labor group(n=53).Cesarean section group received cesarean section under combined spinal and epidural anesthesia,and the transverse incision of the lower abdomen was used;natural labor group received painless delivery.The level of D-D in plasma was detected at admission,3 h,48 h,and 96 h after delivery,and the diagnostic value of the D-D was analyzed by the combination of color Doppler ultrasound results.Result The DVT rate 3 hours after delivery by detecting D-D in cesarean section group was higher than that in the natural labor group,and the difference was statistically significant(P<0.05);there was no significant difference for the DVT rate 48 and 96 h after delivery in two groups(P>0.05).3,48 and 96 h after delivery in cesarean section group and 3 and 48 h after delivery in natural delivery group,the DVT assessed by D-D detection was consistent with the color Doppler ultrasound results.96 h after delivery in natural labor group,color Doppler ultrasound examination showed 3 cases of DVT and D-D detection showed 4 cases,in which 1 was false positive.The area under curve(AUC)of DVT diagnosed by D-D detection in cesarean section group was 0.574(95%CI:0.545-0.598,P=0.001),and the corresponding sensitivity and specificity were 0.744 and 0.378,respectively when the optimal critical value was 1684μg/L.The AUC of DVT by D-D detection in natural delivery group was 0.614(95%CI:0.567-0.660,P<0.01),and the corresponding sensitivity and specificity were 0.587 and 0.714,respectively when the optimal critical value was 1799μg/L.Conclusion D-D detection is fast and economical with higher sensitivity and specificity,which ca
作者
蒯秀琴
姜烜星
魏永梅
孙静
车辙
Kuai Xiuqin;Jiang Xuanxing;Wei Yongmei;Sun Jing;Che Zhe(Department of Clinical Laboratory,Zhang Ye People's Hospital Affiliated to Hexi University,Zhangye 734000,Gansu,China;Department of Vascular Surgery,Zhang Ye People's Hospital Affiliated to Hexi University,Zhangye 734000,Gansu,China)
出处
《血管与腔内血管外科杂志》
2022年第6期749-752,768,共5页
Journal of Vascular and Endovascular Surgery
关键词
D-二聚体
深静脉血栓
诊断价值
分娩方式
剖宫产
D-dimer
deep vein thrombosis
diagnostic value
delivery mode
cesarean delivery
