血浆D-二聚体与纤维蛋白原检测结合超声检查对盆腔手术后下肢深静脉血栓的早期评价价值

目的 研究血浆D-二聚体（D-dimer）与纤维蛋白原（FIB）的动态变化对早期预测盆腔手术后下肢深静脉血栓（DVT）的意义，探讨彩色多普勒超声检查对患者DVT的早期诊断价值。方法 选取2014年1月至2016年1月在首都医科大学附属北京潞河医院妇科择期行盆腔手术并具有DVT高危因素的231例患者为研究对象，术前所有患者下肢深静脉彩色多普勒超声检查均为阴性。根据患者术后72~120 h下肢彩色多普勒超声检查结果，将患者分为血栓组（n=36）和非血栓组（n=195）。所有患者于手术前、术后第1天和术后第3天晨检测D-dimer和FIB，并进行统计分析。结果 血栓组与非血栓组比较，术后D-dimer和FIB显著增高，差异有统计学意义（P<0.05），与术前比较，两组患者术后D-dimer和FIB显著增高，差异有统计学意义（P<0.05）。结论 血浆D-dimer、FIB检测结合彩色多普勒超声检查对妇科盆腔术后患者并发下肢DVT的早期诊断具有重要价值。

Early evaluation of detection of plasma D-dimer and fibrinogen combined with ultrasoundexamination for deep venous thrombosis after gynecological pelvic surgery

Objective To evaluatethe significance of the dynamic changes of plasma D-dimer (D-dimer) and fibrinogen (FIB) in gynecologic pelvic surgery for early prediction of deep venous thrombosis (DVT), and to discuss the early diagnostic value of color Doppler ultrasound in patients with DVT.Methods A total of 231 patients who underwent elective gynecological pelvic surgery and had high risk factors for venous thrombosis from Jan 2014 to Jan 2016 in Beijing Luhe Hospital Affiliated to Capital Medical Universitywere recruited in the study. All patients were negative in preoperatively deep venous color Doppler ultrasonography. Patients were divided into thrombosis groups (n=36) and non-thrombosis group (n=195) according to postoperative 72~120 h Color Doppler ultrasound results of lower extremity.Plasma D-dimer and FIB of all patients were statistically analyzed and compared with those before surgery and postoperative 1stday and in the morning of postoperative 3rd day.Results Compared with non-thrombosis group, postoperative D-dimer and FIB in thrombosis group increased markedly, and the difference was statistically significant (P<0.05).Postoperative D-dimer and FIB of two groups increased significantly compared with preoperative values, and the difference was statistically significant (P<0.05).Conclusion Plasma D-dimer and FIB detection combined with color Doppler ultrasound examination is of important valuefor the early diagnosis of pelvic postoperative DVT of lower extremitiesof patients.