| 牛艳丽,李晓妍,周宇.血流动力学联合血清检测在老年下肢深静脉血栓中的临床意义[J].安徽医药,2023,27(4):742-746. |
| 血流动力学联合血清检测在老年下肢深静脉血栓中的临床意义 |
| Clinical significance of hemodynamics combined with serum detection in elderly patients with DVT of the lower limbs |
| |
| DOI：10.3969/j.issn.1009-6469.2023.04.024 |
| 中文关键词: 静脉血栓形成 股骨颈骨折 超声检查，多普勒，彩色 血流动力学 纤维蛋白单体 D二聚体 |
| 英文关键词: Venous thrombosis Femoral neck fractures Ultrasound, Doppler, color Hemodynamics Fibrin monomer D-dimer |
| 基金项目:四川省卫生和计划生育科研课题资助项目( 16PJ199) |
|
| 摘要点击次数: 593 |
| 全文下载次数: 237 |
| 中文摘要: |
| 目的探讨血流动力学联合血清检测对老年股骨颈骨折( FNF)术后下肢深静脉血栓( DVT)的临床意义表达。方法选取 2018年 5月至 2020年 8月广元市中心医院老年 FNF病人 152例，根据术后下肢 DVT发生情况分为 DVT组( n=31)与无 DVT组(n=121)。比较两组术前、术后血流动力学指标、血清纤维蛋白单体(FM)D-二聚体( D-D)卡普里尼( Caprini)血栓风险评估表评分，并分析其与Caprini血栓风险评估表评分的相关性和其对老年FNF术、后 DVT的诊断价、值以及与治疗结局的相关性。结果 DVT组术后 1d、3d、5d股静脉流速［(17.38±5.29)cm/s、(14.57±3.50)cm/s、(16.15±4.29)cm/s］均显著低于对无 DVT组［(22.76±6.38)cm/s、(18.74±5.18)cm/s、(20.36±6.27)cm/s］(均 P<0.05)DVT组术后 1d、3d、5d腘静脉流速［(13.81±2.59)cm/ s、(7.68±2.68)cm/s、(11.47±3.01)cm/s］均显著低于无 DVT组［( 16.72±2.86，)cm/s、(13.07±4.21)cm/s、(15.88±3.15)cm/s］(均 P<0.05)，DVT组术后 1d、3d、5d血清 FM水平［( 13.76±3.83)mg/L、(21.19±4.23)mg/L、(15.39±3.77)mg/L］均显著高于无 DVT组［( 10.28±2.97)mg/L、(14.75±3.86)mg/L、(12.09±3.18)mg/L］(均 P<0.05)。术后 3d股静脉流速、腘静脉流速与 Caprini评估量表评分呈负相关( r=?0.44，r=?0.46，均 P<0.001)血清 FM、D-D与 Caprini评估量表评分呈正相关( r=0.50，r=0.42，均 P<0.001)；术后 3d股静脉流速、腘静脉流速、血清 FM、D-D合诊断老年 FNF术后 DVT的曲线下面积( AUC)最大为 0.89。股静脉流速、腘静脉流速与治疗结局呈正相关性，血清 FM、D-D与治疗结局呈负相关性( P<0.05)。结论超声检查血流动力学联合血清 FM、 D-D检测有助于提高老年 FNF折术后下肢 DVT的诊断效能，可为临床评估治疗结局提供科学指导。 |
| 英文摘要: |
| Objective To explore the clinical significance of hemodynamics combined with serum detection on deep vein thrombosis (DVT) of the lower limbs after femoral neck fracture (FNF) surgery in the elderly patients.Methods A total of 152 elderly patientswith FNF in Guangyuan Central Hospital from May 2018 to August 2020 were selected and divided into a DVT group (n=31) and a non-DVT group (n=121) according to the occurrence of DVT in the lower limbs after surgery. The preoperative and postoperative hemodynamic indexes, serum fibrin monomer (FM), D-dimer (D-D), and Caprini thrombotic risk assessment scale scores were compared between the two groups, and their correlation with Caprini thrombotic risk assessment scale scores and their diagnostic value for postoperative DVT in elderly FNFs and their correlation with treatment outcomes were analyzed.Results Femoral venous velocities [(17.38±5.29) cm/s, (14.57±3.50) cm/s, (16.15±4.29) cm/s] in the DVT group at 1 d, 3 d and 5 d postoperatively were significantly lower thanthose in the no-DVT group [(22.76±6.38) cm/s, (18.74±5.18) cm/s, (20.36±6.27) cm/s] (P < 0.05)In the DVT group, popliteal flow velocities [(13.81±2.59) cm/s, (7.68±2.68) cm/s, (11.47±3.01) cm/s] at 1 d, 3 d, and 5 d postoperatively were significantly lower than those inthe no-DVT group [(16.72±2.86) cm/s, (13.07±4.21) cm/s, (15.88±3.15) cm/s s] (P < 0.05), and serum FM levels of 1 d, 3 d, 5 d postoperatively in the DVT group [(13.76±3.83) mg/L, (21.19±4.23) ) mg/L and (15.39±3.77) mg/L] were significantly higher than those in theno-DVT group [(10.28±2.97) mg/L, (14.75±3.86) mg/L, (12.09±3.18) mg/L] (P < 0.05). The femoral and popliteal venous flow velocitieswere negatively correlated with the Caprini assessment scale scores at 3 d postoperatively (r=?0.44,?0.46, P<0.001), and serum FM and D-D were positively correlated with the Caprini assessment scale scores (r=0.50, 0.42, P<0.001). The maximum area under thecurve (AUC) for the combined diagnosis of femoral venous flow velocity, popliteal venous flow velocity, serum FM, and D-D for postoperative DVT in elderly FNFs at 3 d postoperatively was 0.89. Femoral venous flow velocity and popliteal venous flow velocity were positively correlated with treatment outcome, and serum FM and D-D were negatively correlated with treatment outcome (P < 0.05).Conclu?sion Ultrasound hemodynamics combined with serum FM and D-D detection can help improve the diagnostic efficiency of lower limbDVT after FNF fracture in the elderly and can provide scientific guidance for the clinical evaluation of treatment outcomes. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
