【摘要】：目的 探討D-二聚體及血栓彈力圖(TEG)在預測全髖關節(jié)置換術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月在該院關節(jié)外科行全髖關節(jié)置換的患者93例,動態(tài)監(jiān)測置換前及置換后1、3、5、7和12 d的D-二聚體,并定期檢測TEG各項指標,置換后12 d行雙下肢靜脈彩超,根據彩超結果有無血栓形成分為血栓組與對照組。對比兩組患者D-二聚體及TEG各項指標的水平。結果 患者術后定期行患側肢體血管彩超檢查,術后1周內行彩超檢查未發(fā)現血栓形成,術后第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)現血栓,納入對照組。兩組患者在年齡、吸煙史,體重、手術時長及術中失血量比較,差異無統(tǒng)計學意義(P0.05)。血栓組與對照組術前及術后1、3、5、7和12 d D-二聚體水平比較,差異有統(tǒng)計學意義(P0.05),所有患者術后較術前凝血反應時間(R)縮短,血栓最大幅度(MA)升高,伴α角升高。術后第12天血栓組TEG的R時間、凝固時間、a角、MA、凝血塊強度值及D-二聚體與對照組比較,差異有統(tǒng)計學意義(P0.05)。結論 提示髖關節(jié)置換術后D-二聚體的動態(tài)監(jiān)測及TEG、小腿肌間靜脈叢彩超檢查有助于早期發(fā)現血栓。
[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：2368213