摘要
目的 分析血栓弹力图、D-二聚体联合检测在骨科术后深静脉血栓形成中的诊断价值。方法 选择潍坊市中医院2020年10月-2021年10月骨科手术患者82例为研究对象,患者于术前、术后采集静脉血液,进行TEG、D-二聚体检测,分析对术后深静脉血栓形成的诊断价值。结果 患者术后血液处于不同程度的高凝状态,R值、K值明显低于术前(P<0.05);Angle值、MA值高于术前(P<0.05);D-二聚体明显高于术前(P<0.05)。术后患者血液高凝状态的监测中,R值、K值、Angle值、MA值检出率为73.17%,6.09%,20.73%,4.87%;82例患者术后经彩色多普勒超声诊断证实发生深静脉血栓者8例,阳性率为9.76%,其中TEG检出阳性率为37.50%,D-二聚体检出阳性率为12.50%,二者联合检出率为87.50%,明显高于单项检测(P<0.05)。结论 骨科患者术后血液即出现高凝状态,TEG是判断骨科围术期高凝状态的敏感指标之一,TEG和D-二聚体联合检测可用于监测骨科围术期凝血状态变化,可作为诊断DVT的一项重要方法。
Objective To analyze the diagnostic value of thromboelastogram and D-dimer in deep venous thrombosis after orthopedic surgery. Methods 82 patients with orthopedic surgery in Weifang Hospital of traditional Chinese medicine from October 2020 to October 2021 were selected as the research object,Venous blood was collected before and after operation for TEG and D-dimer detection,To analyze the diagnostic value of both in patients with postoperative deep venous thrombosis.Results The patients’ blood was in hypercoagulable state in different degrees after operation.The R value and K value were significantly lower than those before operation(P<0.05);the angle value and MA value were higher than those before operation(P<0.05);and the D dimer was significantly higher than that before operation(P<0.05);In the monitoring of blood hypercoagulability after operation,the detection rates of R value,K value,angle value and MA value were73.17%,6.09%,20.73%,4.87%.After operation,8 of 82 patients were confirmed to have deep venous thrombosis by color Doppler ultrasound,the positive rate was 9.76%,of which the positive rate of TEG was 37.50%,the positive rate of D-dimer was 12.50%,and the combined detection rate of D-dimer and TEG was 87.50%,which was significantly higher than that of D-dimer and TEG(P<0.05).Conclusion Orthopedics patients have hypercoagulable blood state after operation.TEG is one of the sensitive indexes to judge the hypercoagulable state during orthopedic perioperative period.The combination of TEG and D-dimer can be used to monitor the changes of coagulation state during orthopedic perioperative period.The combined monitoring of TEG and D-dimer can improve the detection rate of DVT after orthopedic surgery and can be used as an important detection method for the diagnosis of DVT.
作者
胡学亭
李玉娟
庄文玉
Hu Xueting;Li Yujuan;Zhuang Wenyu(The Traditional Chinese Medicine Hospital of Weifang City,Weifang,Shandong 261041)
出处
《基层医学论坛》
2023年第4期69-72,共4页
The Medical Forum
基金
潍坊市卫生健康委员会计划项目(WFWSJK-2020-102)。
