摘要
目的分析彩色多普勒超声联合术前凝血指标检测对骨折后下肢深静脉血栓(DVT)的预测价值。方法选取2019年9月—2022年3月80例创伤性骨折患者,根据术后住院期间并发DVT情况分为DVT组29例与非DVT组51例。患者术前接受凝血指标检测,术后行彩色多普勒超声检查。比较2组检查结果,分析彩色多普勒超声、凝血指标与DVT的关系。结果DVT组术前纤维蛋白原(FIB)、D-二聚体(D-D)水平高于非DVT组,差异有统计学意义(P<0.05)。DVT组血管内径、血流速度、舒张末期速度小于非DVT组,差异有统计学意义(P<0.05)。Logistic回归分析显示,血流速度、舒张末期速度、FIB、D-D是骨折患者术后住院期间并发DVT的影响因素(P<0.05)。血流速度、舒张末期速度、FIB、D-D水平单独预测骨折患者术后住院期间发生DVT的曲线下面积(AUC)依次为0.781、0.720、0.753、0.705,4项指标联合预测的AUC为0.952。结论术前FIB、D-D水平升高以及术后血流速度、舒张末期速度降低是骨折患者术后住院期间并发DVT的危险因素,4项指标联合预测骨折患者术后住院期间并发DVT有一定的临床参考价值。
Objective To analyze the value of color Doppler ultrasound combined with preoperative coagulation indexes detection in predicting deep venous thrombosis(DVT)of lower limbs after fracture.Methods From September 2019 to March 2022,80 patients with traumatic fracture were selected and divided into DVT group(n=29)and non-DVT group(n=51)according to the incidence of DVT during hospitalization after surgery.The patients received blood coagulation test before operation and color Doppler ultrasonography after operation.The results of examinations were compared between the two groups,and the relationships of DVT with color Doppler ultrasound and coagulation indexes were analyzed.Results The levels of fibrinogen(FIB)and D-dimer(D-D)in the DVT group were significantly higher than those in the non-DVT group(P<0.05).The inner diameter,blood flow velocity and end diastolic velocity of blood vessels in the DVT group were significantly lower than those in the non-DVT group(P<0.05).Logistic regression analysis showed that blood flow velocity,end diastolic velocity,FIB and D-D were the influencing factors of postoperative DVT during hospitalization in patients with fracture(P<0.05).The area under the curve(AUC)of blood flow velocity,end diastolic velocity,FIB and D-D levels in predicting the occurrence of DVT independently in fracture patients during hospitalization after surgery were 0.781,0.720,0.753 and 0.705 respectively,and the AUC of combination of the four indicators was 0.952.Conclusion The increase of FIB and D-D levels before operation and the decrease of blood flow velocity and end diastolic velocity after operation are the risk factors of DVT in fracture patients during hospitalization after operation,and the combination of four indicators has the certain clinical reference value in predicting DVT in fracture patients during hospitalization after operation.
作者
张玮
李阳
ZHANG Wei;LI Yang(Department of Ultrasound,Bengbu City Third People′s Hospital in Anhui Province,Bengbu,Anhui,233000;Department of Ultrasound,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui,233000)
出处
《实用临床医药杂志》
CAS
2022年第24期20-23,共4页
Journal of Clinical Medicine in Practice
基金
安徽省教育厅重点项目(KJ2020A0582)。
关键词
彩色多普勒超声
凝血指标
骨折
下肢深静脉血栓
预测价值
color Doppler ultrasound
coagulation indexes
fracture
deep venous thrombosis of lower limbs
predicting value
