【摘要】 目的探讨老年髋部骨折患者预防深静脉血栓形成(DVT)的FIB与D-D聚体预警系统的临床研究。方法收集2018年1月～2019年12月在我院治疗的60例老年髋部骨折患者,将其作为研究对象,根据术后下肢静脉彩超诊断有无DVT,分为DVT组和非DVT组,比较不同时间点两组患者血浆FIB和D-D水平,比较手术前后两组各项生化指标。结果入院时两组血浆FIB水平比较,差异无统计学意义(P> 0.05),术前1d及术后1、3、7d非DVT组的FIB水平均显著低于同时间点DVT组,差异有统计学意义(P <0.05),非DVT组在入院时、术前1d及术后1、3、7d的D-D聚体水平均低于同时间点DVT组,差异有统计学意义(P <0.05),术前两组各项生化指标水平比较,差异无统计学意义(P> 0.05),术后非DVT组APTT、PT水平高于DVT组,差异有统计学意义(P <0.05),非DVT组CRP、PLT水平低于DVT组,差异有统计学意义(P <0.05)。结论采用FIB与D-D聚体联合检测,建立FIB与D-D聚体的预警系统,可有效预防老年髋部骨折患者DVT的发生,在临床上具有推广应用价值。更多还原

【Abstract】 Objective To explore the clinical study of fibrinogen(FIB) and D Dimer(D-D)early warning system for prevention of deep vein thrombosis(DVT) in elderly hip fracture patients. Methods A total of 60 elderly hip fracture patients treated in our hospital from January 2018 to December 2019 were selected as the research subjects.They were divided into DVT group and non-DVT group according to the diagnosis of postoperative lower extremity venous ultrasonography for DVT. The plasma FIB level and plasma D-D level were compared between the two groups at different time points,and the biochemical indicators of the two groups before and after surgery were compared. Results There was no statistically significant difference in plasma FIB levels between the two groups on admission(P > 0.05). The FIB levels in the non-DVT group 1 d before surgery and 1 d,3 d,7 d after surgery were significantly lower than those in the DVT group at the same time,and the differences were statistically significant(P < 0.05). The level of D-D in nonDVT group on admission,1 d before surgery and 1 d,3 d,7 d after surgery was lower than those in the DVT group at the same time point,and the differences were statistically significant(P < 0.05). There was no statistically significant difference in the levels of various biochemical indicators between the two groups before surgery(P > 0.05). After surgery,activated partial thromboplastin time(APTT) and prothrombin time(PT) levels in the non-DVT group were higher than those in the DVT group,and the differences were statistically significant(P < 0.05). The C-reactive protein(CRP) and platelets(PLT)in the non-DVT group were lower than those in the DVT group,the differences were statistically significant(P < 0.05). Conclusion The establishment of early warning system based on joint detection of FIB and D-D can effectively prevent the occurrence of DVT in elderly hip fracture patients,and has clinical application value.更多还原