Evaluation value of D-dimer dynamic monitoring on the occurrence of deep venous thrombosis of lower limb in patients with lower limb fracture during perioperative period
摘要目的 探讨D-二聚体动态监测对下肢骨折患者围术期下肢深静脉血栓（DVT）的评估价值。方法 回顾性分析2019年2月～2020年2月新余第二医院收治的80例下肢骨折围术期患者的临床资料，所有患者均采用切开复位内固定术治疗，根据手术后患者是否形成DVT，分为DVT 组（发生DVT，n=8）与非DVT 组（未发生DVT，n=72）。对比两组的D-二聚体水平，并用受试者工作特征（ROC）曲线图评价动态监测D-二聚体变化对下肢骨折围术期发生DVT 的诊断效能。结果 两组术前的D-二聚体水平比较，差异无统计学意义（P＞0.05）；两组术后1、3、7、14 d 的D-二聚体水平均高于术前，差异有统计学意义（P＜0.05）；DVT 组患者术后1、3、7、14 d 的D-二聚体水平均高于非DVT 组，差异有统计学意义（P＜0.05）；绘制ROC曲线，结果显示，术后1、3、7、14 d 的D-二聚体水平对下肢骨折患者围术期发生DVT 预测的ROC曲线下面积（AUC）值分别为：0.882、0.983、0.995、0.949，术后1 d 时的D-二聚体水平对DVT 有一般诊断效能，术后3、7、14 d 时的D-二聚体水平对DVT 有较高诊断效能。结论 D-二聚体动态监测对下肢骨折患者围术期DVT 有较高诊断效能，可作为DVT 的有效诊断工具。
Abstract：Objective To investigate the evaluation value of D-dimer dynamic monitoring for perioperative deep vein thrombosis (DVT) of lower limb in patients with lower limb fractures.Methods A retrospective analysis was performed based on the clinical data of 80 perioperative patients with lower limb fractures admitted to Xinyu Second Hospital from February 2019 to February 2020.All patients were treated with open reduction and internal fixation.According to whether the patients developed DVT after the operation,they were divided into a DVT group (n=8) and non-DVT group(n=72).The D-dimer level of the two groups was compared.The diagnostic efficiency of dynamic monitoring of Ddimer changes on the occurrence of lower limb fractures during the perioperative period was evaluated by receiver operating characteristic (ROC) curve.Results There was no statistically significant difference in D-dimer level between the two groups before operation (P＞0.05).The D-dimer levels at 1,3,7,and 14 d after operation in the two groups were all higher than those before surgery (P＜0.05).In the DVT group,the D-dimer levels of patients at 1,3,7,and 14 d after operation were higher than those in the non-DVT group,and the differences were statistically significant (P＜0.05).The ROC curve was drawn,and the results showed that the area under the ROC curve (AUC) value of the Ddimer levels of 1,3,7,and 14 d after the operation for the prediction of DVT in the perioperative period of lower limb fractures were 0.882,0.983,0.995,and 0.949.The D-dimer level at 1 day after operation has general diagnostic efficiency for DVT,and the D-dimer levels at 3,7 and 14 days after operation had a higher diagnostic efficiency after comparison.Conclusion D-dimer dynamic monitoring has high diagnostic efficiency for perioperative DVT in patients with lower limb fractures,and it can be used as an effective diagnostic tool for DVT.
黄岩；王丽萍；曹艳红. D-二聚体动态监测对下肢骨折患者围术期下肢深静脉血栓发生情况的评估价值[J]. 中国当代医药, 2020, 27(34): 182-184.
HUANG Yan； WANG Li-ping； CAO Yan-hong. Evaluation value of D-dimer dynamic monitoring on the occurrence of deep venous thrombosis of lower limb in patients with lower limb fracture during perioperative period. 中国当代医药, 2020, 27(34): 182-184.
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