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股骨骨折术前血栓弹力图的价值
Hits: 2223   Download times: 1303   Received:September 14, 2004    
作者Author单位UnitE-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)


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.
KEYWORDS: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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