| 脊柱术后血浆D-二聚体浓度变化与深静脉血栓的关系研究 |
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投稿时间：2013-09-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 司文腾 |
SI Wen-teng |
郑州市骨科医院, 河南 郑州 450052 |
Orthopaedics Hospital of Zhengzhou, Zhengzhou 450052, Henan, China |
swteng516@163.com |
| 张华果 |
ZHANG Hua-guo |
河南职工医学院, 河南 郑州 451191 |
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| 孙宜保 |
SUN Yi-bao |
郑州市骨科医院, 河南 郑州 450052 |
Orthopaedics Hospital of Zhengzhou, Zhengzhou 450052, Henan, China |
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| 白玉 |
BAI Yu |
郑州市骨科医院, 河南 郑州 450052 |
Orthopaedics Hospital of Zhengzhou, Zhengzhou 450052, Henan, China |
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| 期刊信息：《中国骨伤》2014年，第27卷，第5期，第405-408页 |
| DOI：10.3969/j.issn.1003-0034.2014.05.013 |
| 基金项目: |
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中文摘要:
目的：研究脊柱术后D-二聚体（D-dimer）浓度的变化与深静脉血栓（DVT）发生率的关系。
方法：回顾性分析2009年10月至2010年10月收治的63例脊柱手术患者，其中男40例，女23例；年龄21～76岁，平均48岁。颈椎疾病15例，胸椎疾病4例，腰椎疾病44例。外伤骨折患者30例，非外伤患者33例，合并神经损伤11例。根据血浆D-dimer 浓度≥500 μg/L为阳性，<500 μg/L为阴性的标准，把病例分为D-dimer阳性组和D-dimer阴性组。分别取入院时、术后2 h及术后1、2、3、4、6、8、10、15 d不同时间点的清晨空腹静脉血。
结果：两组患者性别、手术部位、植入物、体位、年龄、出血量、体重及术前血浆D-dimer 浓度比较差异无统计学意义。63例中19例术后D-dimer≥500 μg/L，呈持续性或进行性升高，2例DVT阳性，分别于术后3 d及5 d发现，均为外伤性腰椎骨折后路减压内固定术后，均出现在D-dimer阳性组，D-dimer阴性组中无DVT发生。
结论：脊柱术后D-dimer浓度的监测可以有效筛查DVT的发生。 |
| 【关键词】脊柱疾病 脊柱骨折 手术后并发症 血浆D-二聚体 深静脉血栓形成 |
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| Correlation analysis on plasma D-dimer level with deep venous thrombosis after spinal surgery |
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ABSTRACT
Objective: To analyze the relation of plasma D-dimer levels and incidence of deep venous thrombosis after spinal surgery.
Methods: The clinical data of 63 patients underwent spinal surgery from October 2009 to October 2010 were retrospective analyzed. There were 40 males and 23 females with an average age of 48 years old(21 to 76) in operation. Operation levels of 15 cases were in cervical vertebrae,4 cases were in thoracic vertebrae,and 44 cases were in lumbar vertebrae. Thirty patients with spinal fracture were caused by trauma and 33 patients without trauma,11 patients combined with nerve injury. The patients were divided into two groups according to plasma D-dimer levels,more than or equal to 500 μg/L was D-dimer positive group and less than 500 μg/L was D-dimer negative group. Venous blood of all patients early morning with empty stomach were testd on admission,and at 2 h,1 d,2 d,3 d,4 d,6 d,8 d,10 d,15 d after operation,respectively.
Results: There was no statistically significant differences in sex,operative segments,implants,operative posture,age,bleed volume,body weight,peroperative D-dimer levels between two groups. After operation,plasma D-dimer of 19 patients were more than or equal to 500 μg/L,with persistent or progressive increasing. Two cases occurred deep venous thrombosis in D-dimer positive group,they respectively were found at 3 days and 8 days after operation. Both of them underwent posterior decompression and internal fixation. However,no deep venous thrombosis was found in D-dimer negative group.
Conclusion: Postoperative D-dimer assay can effective predict deep venous thrombosis occurrence. D-dimer level more than or equal to 500 μg/L will be considered as a risk factor for deep venous thrombosis after spinal surgery. |
| KEY WORDS Spinal diseases Spinal fractures Postoperative complications Plasma D-dimer Deep venous thrombosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 司文腾,张华果,孙宜保,白玉.脊柱术后血浆D-二聚体浓度变化与深静脉血栓的关系研究[J].中国骨伤,2014,27(5):405~408 |
| 英文格式: | SI Wen-teng,ZHANG Hua-guo,SUN Yi-bao,BAI Yu.Correlation analysis on plasma D-dimer level with deep venous thrombosis after spinal surgery[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(5):405~408 |
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