老年脊柱骨折患者围手术期动态监测D二聚体的临床意义

目的 分析探讨老年脊柱骨折患者围手术期血浆D二聚体浓度的变化规律和意义.方法 创伤时相和围手术时相对31例接受保守及手术治疗的老年脊柱骨折患者血浆D二聚体浓度进行动态监测.结果 手术组患者E1,E2,E3,E4时相时所测D二聚体的阳性率均大于非手术组,差异均有统计学意义（P＜0.05）.所有研究对象血浆D二聚体浓度均于创伤早期升高,非手术组患者于创伤后逐渐回落;手术组患者于术后继续升高,并于第1天达到峰值,以后逐渐回落.结论 老年性脊柱骨折患者围手术期D二聚体浓度变化显著,围术期D二聚体浓度的动态监测有助对患者凝血状态的评估,但不能独立预测术后深静脉血栓发生的风险.

Monitoring the change of D-dimer in preoperational time for elder patients with spine fracture

Objective To monitor the change of D-dimer in perioperational time for elder patients with spine fracture and to discuss the meaning. Methods 31 elders patients who were suffered spine fracture were grouped into surgery team and non-surgery team,all of patients were detected D-dimer at the time of preioperation. Results D-dimer positive rate of surgery team is greater than non-surgery team in the phase of E1,E2,E3, E4; the differences were statistically significant（P〈0.05）. D-dimer level of all patients increased in the early time of post trauma,the D-dimer level of non- surgery team fall gradually after trauma . the D-dimmer level of surgery team continue to rise after sugary and arrival peak on the first postoperative day, then, gradually decline. Conclusion The change of D-dimmer level in the elder patients with spine fracture in the preoperational time is significantly. Monitoring of D-dimmer level may help assessing blood coagulation state, but there is little evidence that D-dimmer could predict the risk of deep vein thrombosis independently.