The Study Of Change Trendency And Clinical Significance About Early Postoperative Blood Coagulation State Between Diabetes Patients And Simple Osteoarthritis Patients After Primary TKA

ObjectiveTo study the change trend in the Primary total knee arthroplasty(TKA)of postoperative blood prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),FIBrinogen(FIB)platelet count(PLT),in osteoarthritis,between diabetes patients and the patients of fasting blood glucose levels normal,and its clinical significance.MethodsThis experiment use the retrospective and controlled study.The research object in December 2014 to December 2016 from our hospital with osteoarthritis,and all of the patients undergoing primary TKA surgery,and preoperative routine fasting blood glucose levels.According to the situation of fasting blood glucose levels,divided thepatients into two groups: diabetes group and normal fasting glucose group(normal group).Patients with diabetes mellitus group into a total of 30 cases,25 cases of women and men in 5 cases,age(60-85 years).Primary TKA surgery over the same period of fasting blood glucose in patients with normal selecting correspond to diabetes patients age,sex or consistent as normal group of 30 patients,women 26 cases,4 cases were male,age(60-85).Diabetes and normal fasting glucose group(normal group)in the same subjects,but diabetes treatment,to control blood sugar levels in the perioperative period clinical intervention,and give the same treatment.Observed two groups of patients with osteoarthritis in primary TKA preoperative andpostoperative 1 day,3 days and 7 days,after operation,postoperative blood PT,TT,APTT,FIB and PLT transformation trend of the situation,and through the analysis of the change tendency,expressed by the reflects its clinical significance.Results1.Two groups of patients with postoperative blood FIB change trend are rise in postoperative day 1,in day 3 to the peak(diabetes group = 5.25 g/L,normal group =4.44 g/L).While the FIB level in postoperative day 7 were Less than postoperative day 3,but still more than preoperative level,and diabetes group patients’ blood FIB levels in all time points after surgery is on the high side Relative to the normal group and its have statistically difference.2.Two groups of patients in the blood PLT count of have the same change trend,postoperative day 1 compared with preoperative declined obviously,in day 3 were down to a minimum(diabetes group= 203.60 * 109/ L,normal group=209.80 * 109 /L).In day 7,two groups of patients’ platelet level were recovered to preoperative levels.And two groups of patients at each time point of PLT count were no statistical differences.3.Two groups of patients ’TT and APTT and PT values are compared,and these three sets of data compare between two groups in different time points didn’t have statistically significant.The three sets of data in each group in different time points,in addition to diabetes group of preoperative and postoperative day 1 TT value,APTT value had statistically significant,other didn’t have statistically significant.These three indicators didn’t have significant change trend,change in the normal range.Conclusion1.The Blood’s high condensation state is serious in the diabetics patients than the patients with normal fasting glucose after primary TKA.2.The blood coagulation parameters,FIB,showed the change trend that increased first,then declined after TKA surgery in the patients with knee osteoarthritis,and It can dynamically reflect the early coagulation function of the body throughexmine the transformation trend of FIB.