本文關(guān)鍵詞：下肢骨折部位與下肢深靜脈血栓發(fā)生的相關(guān)性研究　出處：《江蘇大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 下肢骨折 下肢深靜脈血栓 超聲 D-二聚體

【摘要】：目的:通過(guò)分析不同部位下肢骨折患者的D-二聚體水平、血栓發(fā)生率及發(fā)生部位來(lái)研究下肢骨折部位與下肢深靜脈血栓(Lower ex trem ity deep vein thrombosis,LE DVT)發(fā)生的相關(guān)性。方法:將本院骨科自2012年1月至2015年12月收治入院的下肢單側(cè)單部位骨折患者納入觀察樣本,以下肢血管超聲檢查檢查為L(zhǎng)EDVT的篩查及診斷方式。按骨折部位將患者分為5組:足踝骨折、小腿骨折、膝部骨折、股骨干骨折、股骨近端骨折,分析骨折發(fā)生側(cè)與血栓發(fā)生側(cè)的關(guān)聯(lián)、各組骨折患者的D-二聚體水平及血栓發(fā)生率;統(tǒng)計(jì)各骨折組血栓的部位,按罹患肺栓風(fēng)險(xiǎn)的高低將各骨折組發(fā)生的下肢深靜脈血栓分為高風(fēng)險(xiǎn)血栓(乆靜脈及乆靜脈以上)及低風(fēng)險(xiǎn)血栓(乆靜脈以下),研究各骨折組血栓中高、低風(fēng)險(xiǎn)血栓的分布是否有差異。結(jié)果:在血栓發(fā)生側(cè)與骨折側(cè)的相關(guān)性研究中,共127例骨折后形成LE DVT患者,其中左下肢骨折患者73例、右下肢骨折患者54例;其中122例累及單側(cè)下肢、5例累及雙側(cè)下肢,共累及132處單側(cè)下肢,其中左下肢血栓72處、右下肢血栓60處;發(fā)生在骨折同側(cè)的119處,對(duì)側(cè)的13處。LEDVT更易發(fā)生在骨折的同側(cè)(P0.05),血栓的左右側(cè)分布與骨折的左右側(cè)分布無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),并且下肢骨折患者發(fā)生的LEDVT的左右側(cè)分布與總體LED VT患者的血栓左右側(cè)分布有差異(P0.05);在各組骨折患者中,足踝部骨折組患者的D-二聚體水平(1.81 3.20mg/L)及血栓發(fā)生率(0.4%)均低于其它各組(小腿骨折組:3.70 3.95mg/L、3.4%,膝部骨折組:4.26 6.18 mg/L、6.6%,股骨干骨折組:4.49 6.08 mg/L、5.1%,股骨近端骨折組:4.93 5.99 mg/L、5.8%),并且差異有統(tǒng)計(jì)學(xué)意義(P0.05),而其余骨折組間的D-二聚體水平及血栓發(fā)生率的差異無(wú)顯統(tǒng)計(jì)學(xué)意義(P0.05);在各骨折組血栓的高、低風(fēng)險(xiǎn)血栓分布的統(tǒng)計(jì)中發(fā)現(xiàn)膝部骨折組、股骨干骨折組及股骨近端骨折組的高風(fēng)險(xiǎn)血栓所占比依次為66.7%、68.2%、61.3%,均高于小腿骨折組的25.9%(P0.05),而膝部、股骨干、及股骨近端骨折組的高風(fēng)險(xiǎn)血栓所占比的差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:下肢骨折發(fā)生后,血栓更易發(fā)生在骨折的同側(cè),左右側(cè)的分布無(wú)明顯差異;足踝部骨折組患者的D-二聚體水平及血栓發(fā)生率較其它組骨折低;膝部、股骨干、股骨近端骨折組患者的血栓發(fā)生率高,且以肺栓罹患風(fēng)險(xiǎn)較高的乆靜脈及以上靜脈血栓為主。
[Abstract]:Objective: through the analysis of different parts of patients with lower limb fractures D- two dimer level, rate and location of lower limbs and deep vein thrombosis of lower extremity fractures (Lower ex trem ity deep thrombosis, vein thrombosis, LE DVT). The correlations between methods: the hospital department of orthopedics from January 2012 to December 2015 admitted to the unilateral single lower limb fracture patients included in the study sample, the lower limb vascular ultrasound examination for the diagnosis and screening of LEDVT. According to the fracture patients were divided into 5 groups: ankle fractures, leg fracture, knee fracture, femoral bone fracture, proximal femoral fractures, fracture analysis and thrombosis associated side side, with D- two the level of D-dimer and the incidence of thrombosis were fracture; fracture group statistics the thrombus, suffering from pulmonary embolism according to the risk level of each fracture group had lower extremity deep venous thrombosis were divided into high risk of thrombosis ( The above person vein and vein) and low risk of people (people, following venous thrombosis) on the fracture group of thrombosis in the high, low risk distribution of thrombosis. Results: whether there are differences in correlation between thrombosis and lateral fracture side, the formation of LE DVT in patients with a total of 127 cases of fracture, including 73 cases of left lower extremity fracture, 54 cases of patients with right lower extremity fractures; 122 cases with unilateral lower limb, 5 cases involving the lower extremities, involving a total of 132 unilateral lower extremity, which left lower limb thrombosis in 72, right lower limb thrombosis at 60; 119 occurred in 13 fractures of ipsilateral, contralateral.LEDVT were more prone to fracture in the same the side (P0.05), left and right side of thrombosis and no significant difference in the distribution of the distribution of left and right sides of fracture (P0.05), left and right side and distribution in patients with lower limb fractures occurred in LEDVT and LED VT in patients with thrombosis of the overall lateral distribution is different in each group (P0.05); fractures in patients with ankle fracture group With two D- dimer level (1.81 3.20mg/L) and the incidence of thrombosis (0.4%) was lower than that of other groups (leg fracture group: 3.70 3.95mg/L, 3.4%, knee fracture group: 4.26 6.18 mg/L, 6.6%, femoral fracture group: 4.49 mg/L 6.08, 5.1%, 4.93 proximal femoral fracture group: 5.99 mg/L, 5.8%), and the difference was statistically significant (P0.05), while the remaining fracture group between two D- dimer levels and the incidence of thrombosis showed no difference statistically significant (P0.05); in the fracture group thrombosis, knee fracture group found statistical distribution of thrombosis in low risk, high risk of thrombosis group and fracture of femur shaft fractures of the proximal group shares proportion was 66.7%, 68.2%, 61.3%, were higher than that of leg fracture group of 25.9% (P0.05), and knee femoral shaft, high risk of thrombosis and proximal femoral fracture group the proportion of the difference was not statistically significant (P0.05). Conclusion: the occurrence of thrombosis after lower limb fracture. Is more likely to happen On the same side of the fracture, no significant difference between the distribution of left and right side of the two; the level of D-dimer and the incidence rate of thrombosis was higher than that of the other group and low group of patients with D- fracture of ankle fracture; knee, femur, proximal femoral fractures in patients with high incidence of thrombosis, and pulmonary embolism in high risk people and vein the above vein thrombosis.

【學(xué)位授予單位】：江蘇大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R683

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 畢世偉,修春娥;老年人下肢骨折術(shù)后的心理分期及護(hù)理[J];實(shí)用護(hù)理雜志;2000年03期

2 王洪仙,王淑萍,時(shí)秋英;小兒多發(fā)性下肢骨折的健康教育及護(hù)理指導(dǎo)[J];實(shí)用骨科雜志;2001年06期

3 戴香秀;淺談下肢骨折病人拐杖的選擇與應(yīng)用[J];中醫(yī)正骨;2001年07期

4 許文華;下肢骨折病人的護(hù)理[J];職業(yè)與健康;2001年03期

5 施楚君;下肢骨折高齡患者的護(hù)理體會(huì)[J];安徽醫(yī)學(xué);2003年01期

6 劉新景,張迪;肢體抬高在下肢骨折中應(yīng)用觀察[J];中原醫(yī)刊;2005年02期

7 付麗華;搬運(yùn)下肢骨折病人的體會(huì)[J];護(hù)理研究;2005年10期

8 石虹;;高齡下肢骨折265例護(hù)理體會(huì)[J];齊魯護(hù)理雜志;2006年04期

9 聶青;王淑琴;;自制“愛(ài)心褲”在下肢骨折病人中的應(yīng)用[J];護(hù)理研究(上旬版);2006年19期

10 薩仁高娃;;下肢骨折病人的護(hù)理體會(huì)[J];中國(guó)民族醫(yī)藥雜志;2006年05期

相關(guān)會(huì)議論文 前10條

1 廖芳;潘麗旭;;下肢骨折石膏固定病人的護(hù)理體會(huì)[A];玉溪市第二屆骨科學(xué)術(shù)研討及科技成果推廣會(huì)論文匯編[C];2005年

2 李紅玲;;下肢骨折病人的后期康復(fù)指導(dǎo)[A];中華護(hù)理學(xué)會(huì)全國(guó)中醫(yī)、中西醫(yī)結(jié)合護(hù)理學(xué)術(shù)交流暨專(zhuān)題講座會(huì)議論文匯編[C];2009年

3 李紅玲;;下肢骨折病人的后期康復(fù)指導(dǎo)[A];河南省中醫(yī)、中西醫(yī)結(jié)合護(hù)理暨中西醫(yī)骨傷護(hù)理研討觀摩交流會(huì)議論文集[C];2009年

4 胡林盛;胡紅芳;韓繼紅;;利用肌力平衡機(jī)理治療下肢骨折的新療法[A];第五次全國(guó)中西醫(yī)結(jié)合骨傷科學(xué)術(shù)交流暨中國(guó)中西醫(yī)結(jié)合學(xué)會(huì)骨傷科專(zhuān)業(yè)委員會(huì)換屆大會(huì)文集[C];2000年

5 譚潔;程薇;;下肢骨折術(shù)后患者的康復(fù)訓(xùn)練[A];全國(guó)外科護(hù)理學(xué)術(shù)會(huì)議暨專(zhuān)題講座論文匯編[C];2000年

6 張春梅;閆喬生;張春彥;;微創(chuàng)技術(shù)在下肢骨折中的應(yīng)用及護(hù)理[A];寧夏醫(yī)學(xué)會(huì)骨科學(xué)分會(huì)第三屆學(xué)術(shù)會(huì)議論文匯編[C];2005年

7 張春梅;閆喬生;張春彥;;微創(chuàng)技術(shù)在下肢骨折中的應(yīng)用及護(hù)理[A];寧夏醫(yī)學(xué)會(huì)骨科學(xué)分會(huì)第三屆學(xué)術(shù)會(huì)議論文匯編[C];2005年

8 朱美玉;;下肢骨折老年患者的心理狀態(tài)與心理干預(yù)[A];全國(guó)第七屆骨科護(hù)理學(xué)術(shù)交流暨專(zhuān)題講座會(huì)議論文匯編[C];2005年

9 李秋霞;周淑玲;楊敏芝;;雙側(cè)多功能整復(fù)器治療下肢骨折的護(hù)理體會(huì)[A];全國(guó)第八屆骨科護(hù)理學(xué)術(shù)交流暨專(zhuān)題講座會(huì)議論文匯編[C];2006年

10 薩仁高娃;;下肢骨折病人的護(hù)理體會(huì)[A];第五屆全國(guó)民族醫(yī)藥學(xué)術(shù)交流大會(huì)論文集[C];2006年

相關(guān)重要報(bào)紙文章 前5條

1 廣東省佛山市中醫(yī)院骨傷科 李祖榮;下肢骨折后先用雙拐鍛煉[N];健康時(shí)報(bào);2008年

2 沈奉天;下肢骨折的術(shù)前、術(shù)后指導(dǎo)[N];衛(wèi)生與生活報(bào);2007年

3 主任醫(yī)師 劉健民;拐杖與下肢骨折[N];家庭醫(yī)生報(bào);2003年

4 林琳;拐杖幫助骨折病人康復(fù)[N];醫(yī)藥養(yǎng)生保健報(bào);2005年

5 何世楨;骨折病人3忌[N];中國(guó)中醫(yī)藥報(bào);2008年

相關(guān)碩士學(xué)位論文 前4條

1 郭軍政;下肢骨折術(shù)前深靜脈血栓的發(fā)生與D-二聚體動(dòng)態(tài)變化的相關(guān)性研究[D];山西醫(yī)科大學(xué);2015年

2 張慧霞;下肢骨折部位與下肢深靜脈血栓發(fā)生的相關(guān)性研究[D];江蘇大學(xué);2017年

3 涂益鴻;紅桃消腫顆粒對(duì)下肢骨折圍手術(shù)期腫脹、血栓前狀態(tài)影響的臨床觀察[D];廣州中醫(yī)藥大學(xué);2015年

4 高勇;IPC預(yù)防下肢骨折術(shù)后深靜脈血栓形成及其促進(jìn)骨折愈合的應(yīng)用價(jià)值分析[D];南昌大學(xué);2006年

，

本文編號(hào)：1357886