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[1]孫瑜,周榮斌.D-二聚體檢測在下肢骨折術(shù)后 并發(fā)深靜脈血栓診斷中的價(jià)值[J].中醫(yī)正骨,2012,24(04):22-23.
　SUN Yu*,ZHOU Rong-bin.*.Study on the values of D-dimer test in the diagnosis of deep venous thrombosis developed after the operation of lower limb fracture[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(04):22-23.
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D-二聚體檢測在下肢骨折術(shù)后 并發(fā)深靜脈血栓診斷中的價(jià)值()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期數(shù):
2012年04期
頁碼:
22-23
欄目:
臨床研究
出版日期:
2012-04-30

文章信息/Info

Title:
Study on the values of D-dimer test in the diagnosis of deep venous thrombosis developed after the operation of lower limb fracture
作者:
孫瑜; 周榮斌
中國人民解放軍北京軍區(qū)總醫(yī)院,北京 100700
Author(s):
SUN Yu*; ZHOU Rong-bin.*
PLA.The Military General Hospital of Beijing,Beijing 100700,China
關(guān)鍵詞:
靜脈血栓形成 骨折 手術(shù)后并發(fā)癥 D-二聚體
Keywords:
Venous thrombosis;  Fractures; bone;  Postoperative complications;  D-dimer
摘要:
目的:探討血漿D-二聚體水平檢測在下肢骨折術(shù)后并發(fā)深靜脈血栓診斷中的價(jià)值。方法:分別在術(shù)前、術(shù)后第3天、術(shù)后第7天采用免疫比濁法檢測122例下肢骨折患者血漿D-二聚體水平; 并分別在術(shù)前及術(shù)后第7天行下肢彩色多普勒超聲檢查。規(guī)定血漿D-二聚體水平>500 ng·L-1為深靜脈血栓陽性,以彩色多普勒檢查的陽性結(jié)果作為深靜脈血栓的診斷標(biāo)準(zhǔn); 應(yīng)用診斷試驗(yàn)的一致性檢驗(yàn)比較2種方法診斷結(jié)果的一致性。結(jié)果:術(shù)后第7天,D-二聚體檢測結(jié)果陽性28例; 彩色多普勒檢查診斷為深靜脈血栓24例。2種方法的一致性較好(Kappa=0.805,P=0.000),靈敏度91.7%,特異度93.9%,準(zhǔn)確度93.4%。深靜脈血栓形成患者術(shù)后血漿中的D-二聚體水平較術(shù)前明顯升高(F=121.960,P=0.000); 且術(shù)后第7天時(shí)明顯高于術(shù)后第3天時(shí)(P=0.000)。結(jié)論:動(dòng)態(tài)監(jiān)測血漿D-二聚體水平對下肢骨折患者術(shù)后并發(fā)深靜脈血栓的早期診斷具有重要價(jià)值。
Abstract:
Objective:To explore the values of D-dimer level test in the diagnosis of deep venous thrombosis(DVT)developed after the operation of lower limb fracture.Methods:One hundred and twenty two patients with lower limb fractures were selected to be carried out the test on plasma D-dimer levels through immune turbidimetry(ITM)before the operation,at the 3rd day and the 7th day after the operation respectively,and color Doppler ultrasonography(CDU)on lower limbers were also carried out on the patients before the operation and at the 7th day after the operation respectively.The plasma D-dimer level being higher than 500 ng·L-1 was specified as DVT-positive.DVT was diagnosed according to the positive result of CDU.The concordance of two diagnostic results were inspected using consistency checking.Results:At the 7th day after the operation,D-dimer testing proved positive in 28 cases,and 24 cases were diagnosed as DVT through CDU.There was a better concordance between D-dimer test and CDU(Kappa=0.805,P=0.000)with sensitivity of 91.7%, specificity of 93.9% and accuracy of 93.4%.After the operation,the plasma D-dimer level of DVT patients was higher than that before the operation(F=121.960,P=0.000),and the level at the 7th day after the operation was obviously higher than that at the 3rd day after the operation(P=0.000).Conclusion:The method of dynamic monitoring of D-dimer level is of great value in the early diagnosis of DVT developed after the operation of lower limb fractures.

參考文獻(xiàn)/References:

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備注/Memo

備注/Memo:
2011-10-25收稿 2012-02-03修回
更新日期/Last Update: 2012-04-30