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在脊椎瘤患者中,手术前的D-dimer与静脉血栓塞栓症风险之间的关联
Seeley Yoo1, Ramzy Ahmed1, Emmy Duerr1
1Duke University School of Medicine, Durham, NC, USA.
Spine
|January 21, 2026
概括
手术前的D-二聚体对预测脊柱瘤患者的静脉血栓栓塞 (VTE),特别是肺栓塞 (PE) 的高灵敏度. 虽然它不是特定的,但有助于评估VTE风险和指导预防.
科学领域:
- 在瘤学瘤学.
- 神经外科 神经外科
- 血管医学 血管医学
背景情况:
- 静脉血栓塞栓症 (VTE) 是脊椎手术中经常出现的一种术后并发症.
- 脊柱瘤患者面临着高风险的VTE,但具体的预测因素仍未得到充分研究.
- 这项研究解决了在这个高风险人群中更好地进行VTE风险分层的需求.
研究的目的:
- 评估术前D-二次体水平对术后静脉瘤风险的预测能力.
- 在接受脊髓瘤手术的成年患者中识别VTE的潜在风险因素.
- 评估D-二次体在预测静脉血栓塞,特别是深静脉血栓塞 (DVT) 和肺栓塞 (PE) 的诊断性能.
主要方法:
- 追溯队列研究分析了134名成年脊柱瘤手术患者的医疗记录 (2021年1月至2024年9月).
- 在患有和没有VTE的患者之间比较了手术前的D-二元水平.
- 使用后勤回归和ROC曲线分析来评估D-二分体的诊断性能并确定最佳值.
主要成果:
- 静脉瘤发病率为DVT的6.7%,PE的9.0%.
- 患有PE的患者与没有PE的患者相比,在手术前的D-二次体水平显著更高 (2,088±2,114 ng/mL) (1,222±1,743 ng/mL;P=0.025).
- 手术前的D-二次体对VTE表现出高灵敏度 (0.88) 和负预测值 (0.97),AUC为0.67;然而,特异性有限. 没有发现D-二次体和DVT之间有显著的关联.
结论:
- 手术前的D-二聚体是脊柱瘤患者静脉瘤风险的敏感,但非特异性指标.
- 在这个队列中,D-二次体在预测PE方面似乎比DVT更有效.
- 这些发现表明,D-二聚物可能有助于为脊柱瘤手术患者量身定制抗凝血预防策略.
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