Abstract:Objective: To investigate the factors associated with the incidence of deep vein thrombosis (DVT) and D-dimer in the patients with femoral shaft fracture. methods: Enrolled in the study were 138 patients with femoral shaft fracture who had been treated from June 2014 to December 2015. They were reseanched according to the presence or absence of DVT. The D-dimmer levels were examined for all the cases on the first day after admission,the day before surgery,the 1st, 3rd, and 5th day after surgery. Results: In this cohort, DVT occurred in 23 cases. 8 cases(5.80%)occurred in 1 to 3 days after injury, and 8 (5.80%) cases were born at postoperative day second. The level of posttraumatic D-dimer was higher than the normal value. In 1 day before surgery, the D-dimer in thrombus group was significantly higher than non thrombus group, the difference was statistically significant (P<0.05), and third days after the surgery D-dimer level decreased gradually. When the D-dimer critical value was 2.31ug/mL, its sensitivity was 0.631 and its specificity 0.509 in the diagnosis of DVT; when the D-dimer critical value was 4.63ug/mL, the sensitivity was 0.481 and the specificity was 0.807 in the diagnosis of DVT. Conclusion: Perioperative DVT may happen in the patients with femoral shaft fracture, mostly involving the near end. Peak time of thrombus was 3 days before injury and 1 day after surgery in both groups. The incidence of DVT may be associated with the injury violence. The appropriate critical value of D-dimer may be 3.6 mg/L In 1 days before surgery. The change trend of D-dimer was similar to that of thrombosis
孙灏, 魏俊强, 王瑜, 闫石. 股骨干骨折患者深静脉血栓形成的时间分布及D-二聚体的诊断价值[J]. 河北医学, 2017, 23(1): 41-44.
SUN Hao, WEI Junqiang, WANG Yu, et al. Deep Vein Thrombosis and D-dimer in Patients with Femoral Shaft Fracture. HeBei Med, 2017, 23(1): 41-44.
[1] 中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志,2016,(36):65~71. [2] 彭志平,林云.彩超对下肢深静脉血栓筛查的意义[J].中国超声医学杂志,2013,29(2):167~169. [3] Smith EB, Parvizi J, Purtill JJ.Delayed surgery for patients with femur and hip fractures-risk of deep venous thrombosis[J].Trauma,2011,70(6):113~116. [4] Swaroopa Pulivarthi, Murali Krishna Gurram.Effectiveness of D-Dimer as a screening test for venous thromboembolism: An Update[J].N Am Med Sci, 2014,6(10): 491~499.