创伤性骨折患者术后凝血功能及纤溶活性指标与深静脉血栓形成的相关性研究

目的观察创伤性骨折患者术后凝血功能及纤溶活性指标与深静脉血栓(DVT)形成的相关性。方法将2010年4月至2014年5月收集的134例创伤性骨折手术患者分成DVT组和非DVT组,其中DVT组24例,选取同时期健康人群110例作为对照组,抽取静脉血,观察不同时间点凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板聚集率(PAgT)、D-二聚体(D-D)、凝血酶-抗凝血酶Ⅲ复合物(TAT)、纤溶酶原活性(PIg)水平变化情况。结果 APTT、PT各组比较差异无统计学意义(P0.05)。术前FIB、PAgT、D-D、TAT含量DVT组非DVT组对照组,而PIg水平DVT组非DVT组对照组,差异有统计学意义(P0.05)。术后第1、3天,DVT组FIB、PAgT、D-D、TAT明显高于非DVT组,PIg则明显低于非DVT组(P0.05);DVT组FIB、PAgT、D-D、TAT、PIg阳性率分别为83.33%、87.50%、100.00%、95.83%和75.00%,明显高于非DVT组的48.18%、40.91%、64.55%、61.82%和52.73%(P0.05);经Logistic回归分析,创伤性骨折患者DVT形成的影响因素有D-D和TAT(OR分别为9.578和10.124,P值分别为0.001、0.003),与其他指标无关(P0.05)。结论 D-D和TAT升高与创伤性骨折DVT形成紧密,是独立危险因素。

Study on correlation between postoperative coagulation function and fibrinolytic activity indexes with deep vein thrombosis in patients with traumatic fracture

Objective To investigate the correlation between the coagulation function and fibrinolytic activity with deep venous thrombosis (DVT) after traumatic fracture operation.Methods One hundred and thirty-four cases of traumatic fracture from April 2010 to May 2014 were divided into the DVT group(24 cases) and non-DVT group,and at the same time 110 healthy people were selected as the control group.The venous blood at different time points was collected for observing the levels change of prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),platelet aggregation rate (PAgT),dipolymer (D-D),thrombin antithrombin complex (TAT),plasminogen activity (PIg) by using appropriate methods.Results There was no difference in APTT and PT groups among the groups(P>0.05).Preoperative FIB,PAgT,D-D and TAT levels was the DVT group >non-DVT group > control group,while the level of PIg was the DVT group0.05).Conclusion The increase of D-D and TAT is closely related with DVT in traumatic fracture and,which is an independent risk factor.