The Study On The Clinical Observation Of Serum D-Dimer In Patients With Acute Pulmonary Embolism During Orthopedics Perioperative Period

Object i veTo investigate the clinical observation of serum D-Dimer levels in patients with acute pulmonary embolism during orthopedics perioperative period, and to provide clinical evidence for the risk assessment of the prognosis of patients in Department of orthopedics perioperative period.MethodsThrough retrospective analysis of January 2011 to January 2016 during the First Affiliated Hospital of Guangzhou University of Chinese Medicine the treatment of patients with acute pulmonary embolism during orthopedics perioperative period, records include age, gender, fracture or the type of bone disease. According to trauma after 24h serum D-dimer level and divided into group A (high concentration group, D-dimer≥5000ng/mL) and group B (low concentration group, D-dimer< 5000ng/mL), the influence of serum D-dimer level, peak value and risk factors on the prognosis of the two groups were statistically analyzed and compared. P<0.05, the difference has statistical significance with comparability.ResultsIncluded a total of 38 diagnosis for patients with acute pulmonary embolism.According to trauma after 24h serum D-dimer level and divided into group A (high concentration group, D-dimer≥5000ng/mL) and group B (low concentration group, D-dimer<5000ng/mL).19 cases in group A, including 5 cases of male and 14 cases of female, the age at the age of 23-88, average age for (63.39+15.633) years; group B (n=19), including 9 males and 10 females, age at the age of 26-95, average age for (67.83+19.018) years old. Two groups of age and gender comparison, P>0.05, the difference has not statistical significance with comparability.The experiment found that there are 36 cases whose serum D-dimer level ≥500ng/mL in atrauma after 24h when it<500ng/mL has 2 cases, the sensitive detection rate of acute pulmonary embolism was 94.739%; Femoral neck fractures occurred in 13 patients with acute pulmonary embolism (34%), but compared with other different parts, P>0.05 was not statistically difference; comparison of admission or operation after 24h serum D-dimer level and peak, the single sample T test independent, P=0.01<0.05, statistical difference was statistically significant; for patients with acute pulmonary risk the degree of risk factors on the prognosis of embolization effect, statistical results showed that the concentration of group factors, P=0.008< 0.05, in the evaluation of acute pulmonary embolism prognosis risk have obvious difference, there is statistical Statistical analysis of the other risk factors, P>0.05, there is not statistical difference.ConclusionThrough this study, we can find that we should conduct the detection of serum D-Dimer levels in patients during orthopedics perioperative period.After a preliminary high risk screening, we can get the further diagnosis from the help of multi slice spiral CT pulmonary angiography (MSCTPA) or pulmonary artery DSA. It has a certain clinical significance for clinical risk assessment. In addition, the detection of serum D-dimer on the prognosis of patients with acute pulmonary embolism assessment is of great significance, can be used as an important index for evaluating the risk degree of the patients and to guide the patients further therapeutic decisions, thereby reducing the risk of death in patients with.