摘要
目的:研究血栓弹力图联合D-二聚体(D-D)在老年股骨颈骨折围术期预测静脉血栓的价值,并分析术后康复效果.方法:选取2022年1月至2023年6月在林州市人民医院诊治的老年股骨颈骨折围术期发生静脉血栓患者62例作为血栓组,并选取同期老年股骨颈骨折围术期未发生静脉血栓患者62例作为非血栓组,比较两组血栓弹力图指标和D-D,并采用二元Logisic回归分析老年股骨颈骨折围术期发生静脉血栓的影响因素,采用ROC曲线分析血栓弹力图指标和D-D联合对老年股骨颈骨折围术期发生静脉血栓的预测价值.结果:血栓组凝血反应时间(R)、凝固时间(K)相较于非血栓组更高(P＜0.05),血栓组凝固角度(α)、最大振幅(MA)、D-D相较于非血栓组更低(P＜0.05).经二元Logisic回归分析,高R、高K是老年股骨颈骨折围术期静脉血栓的保护因素(P＜0.05),高α、高MA是老年股骨颈骨折围术期静脉血栓的危险因素(P＜0.05).联合=R+K×(-3.946/-1.290)+α ×(0.330/-1.290)+MA ×(0.307/-1.290)+D-D×(0.248/-1.290).ROC曲线分析得出,R、K、α、MA、D-D、联合预测老年股骨颈骨折围术期静脉血栓的AUC分别为0.664、0.731、0.792、0.767、0.688、0.981,敏感度分别为 91.9％、82.3％、74.2％、51.6％、48.4％、90.3％,特异度分别为 43.5％、53.2％、75.8％、90.3％、95.2％、95.2％.结论:血栓弹力图联合D-D对老年股骨颈骨折围术期预测静脉血栓具有较高的预测价值,可为其术后康复效果提供辅助参考.
Abstract
Objective:To investigate the value of thromboelastography combined with D-dimer(D-D)in predicting venous thromboembolism during the perioperative period of elderly patients with femoral neck fractures,and to analyze the postoperative rehabilitation outcomes.Methods:A total of 62 elderly patients with femoral neck fractures who developed venous thromboembolism during the perioperative period at Linzhou People's Hospital from January 2022 to June 2023 were selected as the thrombus group.Additionally,62 elderly patients with femoral neck fractures who did not develop venous thromboembolism during the same perioperative period were selected as the non-thrombus group.The thromboelastography parameters and D-D levels were compared between the two groups.Binary logistic regression analysis was used to identify the influencing factors of venous thromboembolism during the perioperative period of elderly femoral neck fractures.The ROC curve was employed to analyze the pre-dictive value of combined thromboelastography parameters and D-D for venous thromboembolism during the perio-perative period of elderly femoral neck fractures.Results:The coagulation reaction time(R)and clot formation time(K)were significantly higher in the thrombus group compared to the non-thrombus group(P＜0.05).Conversely,the angle of clot formation(α),maximum amplitude(MA)and D-D levels were significantly lower in the thrombus group(P＜0.05).Binary logistic regression analysis revealed that high R and high K were protec-tive factors against venous thromboembolism during the perioperative period of elderly femoral neck fractures(P＜0.05),while high α and high MA were risk factors(P＜0.05).Union=R+K ×(-3.946/-1.290)+α ×(0.330/-1.290)+MA x(0.307/-1.290)+D-D x(0.248/-1.290).ROC curve analysis showed that the AUCs for predicting venous thromboembolism during the perioperative period of elderly femoral neck fractures using R,K,α,MA,D-D,and the combined method were 0.664,0.731,0.792,0.767,0.688 and0.981,respec-tively.The corresponding sensitivities were 91.9％,82.3％,74.2％,51.6％,48.4％and 90.3％,while the specificities were 43.5％,53.2％,75.8％,90.3％,95.2％and 95.2％,respectively.Conclusion:Throm-boelastography combined with D-D exhibits high predictive value for venous thromboembolism during the perioper-ative period of elderly patients with femoral neck fractures,providing an auxiliary reference for postoperative reha-bilitation outcomes.
维普
万方数据