1334例创伤骨科患者血浆D-二聚体水平的回顾分析

目的通过对大宗病例的回顾性分析，对不同创伤程度患者的血浆D-二聚体水平进行统计，找出创伤程度与D-二聚体水平之间的关系，并探讨D-二聚体在对创伤骨科患者术前血栓倾向筛查中的应用。方法1334例创伤患者（共1359例次）入院后测得的血浆中D-二聚体含量，其中急性创伤病例858例次，非急性创伤病例501例次，并进行统计学分析。结果急性创伤后患者血浆D-二聚体水平明显高于非急性创伤患者，差异有极显著性（P〈0．01）；急性创伤患者血浆D-二聚体的阳性率亦明显高于非急性创伤患者，差异有极显著性（P〈0．01）；患者全身骨折数量〈5时，骨折数量与血浆D-二聚体水平呈线性相关（r=0．995，P〈0．01）。结论急性创伤患者血浆D-二聚体水平明显增高。当骨折数量〈5时，D-二聚体水平可以辅助评价创伤严重程度。当D-二聚体用于对创伤患者术前血栓倾向的筛查时，应区分急性、慢性及创伤程度，采用不同的参考标准结合临床做出判断。

The Retrospevtive Analysis of D-dimer in 1 334 Trauma Patients

Objective To detect the clinical predictive significance between plasma D-dimer and traumatic degree in trauma patients through retrospevtive research. And based on that to evaluate D-dimer used in screen of presurgery thrombotic tendency of traum patients. Methods Plasma D-dimer in 1 334 trauma patients, （1 359 cases： included 858 acute traumatic cases and 501 chronic traumatic cases）was analysed with statistic retrospectively. Result Plasma D-dimer level was significantly higher in acute traumatic patients than in chronic traumatic patients, and the positiverate of plasma D- dimer level was also significantly higher in acute traumatic patients than chronic traumatic patients, The relationship between the number of fracture and the mean of D- dimer level in acute traumatic patients was linear correlation （ r = 0. 995, P 〈 0.01 ）, when the number of fracture was smaller than 5. Conclusion It is regular that the plasma D- dimer level increases in trauma patients, and the relationship between the D-dimer and the number of fracture in trauma patients is very close. So D- dimer may be used to help juge the degree of trauma. When D- dimer is used in screen of presurgery thrombotic tendency of trauma patients.