股骨骨折术前血栓弹力图的价值
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作者Author单位AddressE-Mail
廖荣宗 LIAO Rong-zong 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China liaorz99@163.com 
区锦燕 OU Jin-yan 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China  
吴征杰 WU Zheng-jie 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China  
罗富荣 LUO Fu-rong 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China  
周曙 ZHOU Shu 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China  
陈耀雄 CHEN Yao-xiong 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China  
彭健泓 PENG Jian-hong. 佛山市中医院 广东佛山528000 Foshan Hospital of Traditional Chinese Medicine,Guangdong Foshan,528000,China  
期刊信息:《中国骨伤》2005年,第18卷,第3期,第129-131页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:广东省中医药管理局资助课题(编号:103144)
中文摘要:

目的:采用血栓弹力图(thrombelastograph,TEG)评价股骨闭合骨折术前的凝血状况,并探讨TEG在评价股骨骨折术前高凝状态的意义。

方法:Ⅰ组为对照组,11例健康献血员,清晨空腹静脉采血。Ⅱ组为实验组,26例,为未经抗凝治疗的股骨闭合性骨折患者,分别于骨折第2天(Ⅱ2d)和第8天(Ⅱ8d)清晨空腹静脉采血。实验采用双盲法,专人检测。两组静脉血样均进行TEG检测。

结果:Ⅰ组TEG的各参数结果正常。Ⅱ组中Ⅱ2d和Ⅱ8d的TEG:α角、血栓最大幅度MA值、血栓硬度G值均增大,与Ⅰ组比较差异有显著性意义;Ⅱ组中Ⅱ8d与Ⅱ2d比较,血栓最大幅度MA值和血栓硬度G值增大,均有统计学差异。

结论:股骨骨折第2天和第8天均存在不同程度的高凝状态,而且有逐步加重趋势;TEG是创伤骨折及术前预测和判断血液高凝状态的有力指标,如TEG揭示高凝状态存在,应采取有力措施预防下肢深静脉血栓的形成,并尽早防治。
【关键词】股骨骨折  静脉血栓形成  血栓弹力描记术
 
The value of preoperative thrombelastograph in fracture of the femur
ABSTRACT  

Objective:To evaluate the preoperative thromboxane functions in closed fracture of the femur by thrombelastograph (TEG),and evaluate the significance of TEG in blood hypercoagulable state.

Methods:Eleven healthy adults were group Ⅰ (control group),and twenty-six patients who were suffered from closed fracture of the femur and not used the anti-coagulation drugs were group Ⅱ.The patients in group Ⅱ were taken vein blood with empty stomach on the second (Ⅱ 2d) and the eighth (Ⅱ 8d) early morning.The TEG of all blood samples with empty stomach were double-blindly detected by the special messengers.

Results:All parameters of TEG in group Ⅰ were normal.The numerical value of G,MA and α angle in Ⅱ 2d and Ⅱ 8d increased,with significant difference compared with group Ⅰ.The numerical value of G and MA in group Ⅱ 8d increased,with significant difference compared with group Ⅱ 2d.

Conclusion:The preoperative patients of closed fracture of the femur are in blood hypercoagulable state,and become worse step by step.TEG is a powerful index to evaluate blood hypercoagulable state.If TEG shows the blood is in hypercoagulable state before operation,the lower deep venous thrombosis (LDVT) should be prevented and cured.
KEY WORDS  Femoral fractures  Thrombosis,venous  Thrombelastography  
 
引用本文,请按以下格式著录参考文献:
中文格式:廖荣宗,区锦燕,吴征杰,罗富荣,周曙,陈耀雄,彭健泓.股骨骨折术前血栓弹力图的价值[J].中国骨伤,2005,18(3):129~131
英文格式:LIAO Rong-zong,OU Jin-yan,WU Zheng-jie,LUO Fu-rong,ZHOU Shu,CHEN Yao-xiong,PENG Jian-hong..The value of preoperative thrombelastograph in fracture of the femur[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(3):129~131
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