Studies On The Screening Of Deep Vein Thrombosis In Perioperative Of Spinal Degenerative Disease With D-dimer And Wells Score

Objective: To change surgery D-dimer of inquiry in patients undergoing spinaldegeneration and degenerative spine surgery diagnostic value of deep venousthromboembolic disease; clarifing Wells clinical scale joint D-dimer testing thediagnostic value; and to provide for the degeneration of the spine in patients withperioperative D-dimer and Wells score thresholds for clinical classification method,and ultimately around the prevention and early perioperative thromboembolic diseasein patients with degenerative spine clinic found provide a theoretical basis.Methods: This study selected objects since December2011to June2014at theSecond Hospital of Jilin University, Bethune orthopedic hospital inpatient spinesurgery for degenerative spine disease perioperative patients with a total210cases,records patient’s gender, age and surgery with time, blood loss, and preoperative andpostoperative one day, after3days and7days after the detection of patients withplasma D-dimer levels, as well as the first three days after surgery on patients wellsscore, application of color Doppler imaging method for the diagnosis of DVT patients,selected after the first three days D-dimer levels and Wells score, were produced D-dimer and Wells score diagnosis of spinal degenerative disease perioperative DVTROC curve and calculate the area under the curve, draw cut-off value to calculate theappropriate cut-off value of the diagnosis of DVT sensitivity, specificity and Kappavalues, etc. D-dimer and Wells score on bivariate logistic regression analysis, thusmaking D-dimer and Wells score index diagnosis of spinal degenerative joint disease perioperative DVT ROC curve and calculate the area under the curve and cut-offvalue; D-dimer and Wells score based on regression coefficients obtained equation tocalculate the predicted values of individuals. Data analysis by SPSS19.0statisticalsoftware for statistical processing, using Stata12.0software production ROC curve.Results: The results of this experiment show, DVT group and non-DVT patientswere no significant differences in age, gender, operative time and blood loss, etc; D-dimer levels after perioperative patients were gradually increased, in the first threedays after the peak, then decline in their level of visibility;1,3postoperative day7DVT in patients with D-dimer and relatively non-high DVT group, and the differencewas statistically significant; D-dimer diagnosis area under the ROC curve of DVT is0.84, cut-off value of1.14μg/ml, the value of the diagnostic sensitivity of DVT was93.3%, specificity67.2%, accuracy71.0%, kappa value of0.34; ROC curve diagnosisof DVT Wells score under the area of0.75, cut-off value of2.5, the value of thediagnosis of DVT sensitivity70.0%, specificity77.2accuracy76.2%, kappa value of0.33; D-dimer levels and diagnosis of DVT Wells score joint indicators ROC curveunder the area of0.78, cut-off value of0.20, sensitivity66.7%, specificity86.1%,accuracy83.3%, kappa value of0.44.Conclusion: A degenerative spine surrounded D-dimer levels in patients withDVT after surgery was significantly higher than non-DVT patients, and in the firstthree days after D-dimer levels peaked. High2. spinal degeneration Wai D-dimeroperative DVT diagnosis in patients with sensitivity, negative predictive value, butpoor specificity, can be used as indicators of DVT screening.3.Wells score for thediagnosis of DVT, specificity and high sensitivity is poor, misdiagnosis rate, theclinical diagnosis of spinal degeneration perioperative DVT have a certain value.Sensitivity and specificity4.D-dimer and Wells score combined were higher, itsdiagnostic value was significantly better than Wells score alone can be used as a supplementary screening D-dimer after DVT can be reduced misdiagnosis rate,increase the positive predictive value of the diagnosis of degenerative spine surgeryaround the early diagnosis of DVT have greater clinical value.