【摘要】：目的 探討D-二聚體及血栓彈力圖(TEG)在預(yù)測(cè)全髖關(guān)節(jié)置換術(shù)后急性下肢深靜脈血栓(DVT)中的意義。方法 納入2015年12月-2016年5月在該院關(guān)節(jié)外科行全髖關(guān)節(jié)置換的患者93例,動(dòng)態(tài)監(jiān)測(cè)置換前及置換后1、3、5、7和12 d的D-二聚體,并定期檢測(cè)TEG各項(xiàng)指標(biāo),置換后12 d行雙下肢靜脈彩超,根據(jù)彩超結(jié)果有無(wú)血栓形成分為血栓組與對(duì)照組。對(duì)比兩組患者D-二聚體及TEG各項(xiàng)指標(biāo)的水平。結(jié)果 患者術(shù)后定期行患側(cè)肢體血管彩超檢查,術(shù)后1周內(nèi)行彩超檢查未發(fā)現(xiàn)血栓形成,術(shù)后第12天彩超檢查提示11例患者存在小腿肌間靜脈血栓,納入血栓組;其余82例患者未發(fā)現(xiàn)血栓,納入對(duì)照組。兩組患者在年齡、吸煙史,體重、手術(shù)時(shí)長(zhǎng)及術(shù)中失血量比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。血栓組與對(duì)照組術(shù)前及術(shù)后1、3、5、7和12 d D-二聚體水平比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),所有患者術(shù)后較術(shù)前凝血反應(yīng)時(shí)間(R)縮短,血栓最大幅度(MA)升高,伴α角升高。術(shù)后第12天血栓組TEG的R時(shí)間、凝固時(shí)間、a角、MA、凝血塊強(qiáng)度值及D-二聚體與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 提示髖關(guān)節(jié)置換術(shù)后D-二聚體的動(dòng)態(tài)監(jiān)測(cè)及TEG、小腿肌間靜脈叢彩超檢查有助于早期發(fā)現(xiàn)血栓。
[Abstract]:Objective to investigate the significance of D-dimer and thromboelastography (TEG) in predicting acute deep venous thrombosis (DVT) after total hip arthroplasty. Methods from December 2015 to May 2016, 93 patients underwent total hip arthroplasty in our hospital. The D-dimer before and after replacement was monitored dynamically, and the TEG indexes were detected regularly. On the 12th day after replacement, the patients were divided into two groups: thrombus group and control group according to the results of color Doppler ultrasound. The levels of D-dimer and TEG were compared between the two groups. Results Color Doppler ultrasonography was performed regularly in the affected limbs after operation, and no thrombus was found in the first week after operation. On the 12th day after operation, color Doppler ultrasonography showed that 11 patients had intermuscular vein thrombosis in the leg and were included in the thrombus group. The remaining 82 patients without thrombus were included in the control group. There was no significant difference in age, smoking history, body weight, length of operation and blood loss during operation between the two groups (P0.05). The level of D-dimer in the thrombus group was significantly higher than that in the control group (P 0.05). The postoperative coagulation reaction time (R) was shorter and the maximal thrombus (MA) was higher in the thrombus group than in the control group (P 0.05). Accompanied by 偽 -angle elevation. On the 12th day after operation, the R time, coagulation time, a angle, MA, clot intensity and D-dimer in thrombus group were significantly different from those in control group (P0.05). Conclusion dynamic monitoring of D-dimer after hip arthroplasty and color Doppler ultrasound examination of TEG, 's intermuscular venous plexus of lower leg are helpful for early detection of thrombus.
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本文編號(hào)：2368213