Rafee A, Herlikar D, Gilbert R, Stockwell R C, McLauchlan G J
Manchester University, Manchester, UK.
Ann R Coll Surg Engl. 2008 Mar;90(2):123-6. doi: 10.1308/003588408X261627.
The merit of using D-dimer estimations in patients following total hip and knee replacement has been previously questioned. A survey of radiology protocols in 70 hospitals ascertained that the test continues to be mandatory in 51 prior to formal radiological investigation of suspected deep vein thrombosis (DVT) in this patient population.
In this study, D-dimer levels were measured pre-operatively and during the first 7 days following primary total hip and knee replacement to estimate the range of normal values in these patients.
All 78 patients were ultrasonographically shown to be clear of DVT. D-Dimer levels were significantly raised in all patients at all measurements during the first week. Levels after total knee replacement were higher than after total hip replacement. Comparison was made with an age-matched group who had a proven DVT. There was no difference in D-dimer levels between patients with or without a DVT.
The use of this test in this patient group is a waste of resource and merely delays appropriate radiological investigation and treatment.
此前，在全髋关节和膝关节置换术后患者中使用D - 二聚体检测的价值一直受到质疑。一项对70家医院放射学检查方案的调查表明，在对该患者群体疑似深静脉血栓形成（DVT）进行正式放射学检查之前，51家医院仍将该检测作为强制性检查。
在本研究中，对初次全髋关节和膝关节置换术前及术后第1周内的患者进行D - 二聚体水平检测，以评估这些患者的正常数值范围。
所有78例患者经超声检查均显示无DVT。在术后第一周的所有测量中，所有患者的D - 二聚体水平均显著升高。全膝关节置换术后的水平高于全髋关节置换术后。与已证实患有DVT的年龄匹配组进行了比较。有或无DVT的患者之间D - 二聚体水平无差异。
在该患者群体中使用此检测是资源浪费，只会延迟适当的放射学检查和治疗。
