下肢深静脉血栓由肋骨骨折引起的D-二聚体的诊断价值:一个回顾性研究
Lei Feng1, Zexin Xie1, Xuetao Zhou1
1Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang, Shijiazhuang, 050011, Hebei, China.
Journal of orthopaedic surgery and research
|July 20, 2023
概括
在肋骨骨折后24小时测量D-二聚合物水平有助于诊断深静脉血栓 (DVT). 早期检测D-二分体可以提高诊断准确度,并减少这些患者的错误诊断.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 血管医学 血管医学
- 创伤护理 创伤护理
背景情况:
- 下肢深静脉血栓塞 (DVT) 是肋骨骨折患者的潜在并发症.
- 准确及时诊断DVT对于预防不良结果至关重要.
研究的目的:
- 评估D-二聚体在识别患有肋骨骨折的患者深静脉血栓症 (DVT) 的诊断效用.
- 在这个特定的患者群体中评估动态D-二分体监测的有效性.
主要方法:
- 对499名肋骨骨折患者的回顾性分析.
- 在DVT和非DVT组之间的D-二次体水平比较在受伤后的24,48,72小时.
- 使用的接收器操作特征 (ROC) 曲线来确定诊断性能.
主要成果:
- 在所有测量时间点 (24,48,72小时) 中,与非DVT组相比,在DVT组中观察到显著升高的D-二次数水平.
- 预测DVT的曲线下面积 (AUC) 在24小时 (0.788) 最高,在48小时 (0.605) 和72小时 (0.568) 下降.
结论:
- 伤害后24小时的D-二聚体测量表明,在肋骨骨折患者中,对DVT具有显著的诊断价值.
- 早期的D-二次体评估提高了诊断灵敏度,降低了错过DVT诊断的可能性,提供了显著的临床益处.
相关概念视频
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
14
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
14
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15
Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
17
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
17


