D-二聚体检测在胸外科患者术后肺栓塞中的诊断价值

目的探讨D-二聚体检测在胸外科患者术后肺栓塞中的诊断价值。方法回顾性分析2008年-2013年期间我院收治的18 128例胸外科手术治疗患者术后发生肺栓塞的临床资料,并选取其中的35例胸外科手术治疗患者进行D-二聚体检测。结果胸外科手术年龄≧50岁的患者与〈50岁的患者比较,肥胖患者与体重合格者比较,发生恶性肿瘤与良性肿瘤比较,肺栓塞发生率均有显著性差异（P〈0.05）;进行D-二聚体检测诊断肺栓塞的阴性预测值以及敏感性均为100%,假阳性率为94.7%（18/19）。结论行胸外科手术治疗的肥胖、高龄和恶性肿瘤患者术后发生肺栓塞的可能性较大,而采用D-二聚体检测,能够较精确地对肺栓塞进行诊断,阴性结果正确率高,值得临床上进一步推广与研究。

Diagnostic value of D-dimer testing in patients with thoracic surgery postoperative pulmonary embolism

Objective To study the diagnostic value of D-dimer testing in patients with thoracic surgery postopera- tive pulmonary embolism. Methods 18.128 cases of thoracic surgery patients in our hospital during the period of 2008- 2013 were retrospectively analyzed,compared and analyzed the clinical data of postoperative pulmonary embolism, and selected 35 patients with thoracic surgery detecting D-dimer. Results Thoracic surgery patients over 50 years of age compared to 50 patients under 50 years of age, obese patients compared with weight eligible, malignant tumors com- pared to benign tumors, the incidence of pulmonary embolism were significant difference （P~ 0. 05 ） ; after D-dimer checking, the diagnosis of pulmonary embolism in the negative predictive value and the sensitivity was 100 %, false positive rate was 94.7% （18/19）. Conclusion Thoracic surgical treatment of obesity,older age,malignant tumor patients, postoperative pulmonary embolism possibility is larger, and the D- dimer for testing, can accurately to diagnose pulmo- nary embolism symptom, negative high inspection accuracy,worthy of clinical promotion and further study.