本文關(guān)鍵詞： 深靜脈血栓 D-二聚體 骨折 Wells評分　出處：《實(shí)用醫(yī)學(xué)雜志》2016年01期 　論文類型：期刊論文

【摘要】：目的:回顧分析Wells評分聯(lián)合D-二聚體預(yù)測下肢深靜脈血栓(DVT)形成的價值。方法:隨機(jī)選取2013年1月至2015年1月入本院手外科、骨科治療的骨折術(shù)后患者405例,根據(jù)多普勒超聲結(jié)果將其分為DVT組(n=20)和非血栓組(n=385),另選同期接受體檢的40例健康者作為對照組。對疑似DVT的53例患者分別以Wells評分、D-二聚體測定以及兩者聯(lián)合診斷骨折患者術(shù)后并發(fā)DVT的風(fēng)險。結(jié)果:DVT組D-二聚體值明顯高于非血栓組與健康對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.01):ROC曲線分析顯示D-二聚體診斷骨折患者術(shù)后并發(fā)DVT的最佳臨界值為0.575 mg/L,診斷敏感度為90%、特異度為64%,曲線下面積為0.840,P=0.000:根據(jù)Wells評分、D-二聚體以及兩者聯(lián)合對骨折合并DVT診斷的靈敏度分別為80.00%、90.00%、90.00%:特異度分別為75.76%、69.70%、87.88%:準(zhǔn)確度分別為83.02%、77.36%、88.68%:陽性預(yù)測值分別為66.67%、64.29%、81.82%:陰性預(yù)測值分別為86.21%、92.00%、93.55%:陽性似然比分別為3.30、2.97、7.43:陰性似然比分別為0.26、0.14、0.11。結(jié)論:Wells評分聯(lián)合血漿D-二聚體檢測可以預(yù)測骨折患者術(shù)后并發(fā)下肢DVT的風(fēng)險,為患者減少不必要的痛苦和檢查費(fèi)用。
[Abstract]:Objective: retrospective analysis of Wells score combined with two D- dimer prediction of lower extremity deep venous thrombosis (DVT) formation value. Methods: randomly selected from January 2013 to 2015 1 month of hand surgery in our hospital, 405 patients were treated in the Department of orthopedics after fracture, according to the Doppler ultrasound were divided into DVT group (n=20) and non thrombus group (n=385), 40 healthy subjects were selected as control group. The medical examination of 53 cases of suspected DVT patients with Wells score, D- two were tested and their combined diagnosis risk associated with DVT fracture patients after operation. Results: in group DVT, two D- dimer value was significantly higher than that of the control group of non thrombus group and health, the difference was statistically significant (P0.01): ROC curve analysis showed that two D- dimer in diagnosis of fracture patients complicated with DVT optimal threshold was 0.575 mg/L, the diagnostic sensitivity was 90%, specificity was 64%, the area under the curve was 0.840 P=0.000:, according to the Wells score, D- two poly The body as well as the combination of fracture with DVT diagnostic sensitivity were 80%, 90%, 90%, specificity was 75.76%, 69.70%, 87.88% respectively, the accuracy was 83.02%, 77.36%, 88.68%, the positive predictive value were 66.67%, 64.29%, 81.82%: the negative predictive value were 86.21%, 92%, 93.55%: positive likelihood ratio were 3.30,2.97,7.43: negative likelihood ratio was 0.26,0.14,0.11. conclusion: Wells score combined with the serum D- two dimer detection can predict the risk of lower extremity DVT fracture patients, for patients to reduce unnecessary pain and examination fees.

【作者單位】： 蘇州大學(xué)附屬無錫九院檢驗(yàn)科;
【分類號】：R619;R446.11
【正文快照】： 骨折患者術(shù)后由于血管內(nèi)膜損傷、血液流動瘀滯、炎性介質(zhì)釋放,其血液常處于高凝狀態(tài),如處理不當(dāng),很容易誘發(fā)下肢深靜脈血栓(deep veinthrombosis,DVT)[1],故許多學(xué)者對其研究高度重視[2-3]。目前有多種方法可以輔助醫(yī)生診斷DVT,包括Wells評分、血漿D-二聚體檢測、彩色多普勒超，

本文編號：1455352