肌肉骨骼肿瘤患者围手术期的D-二聚体水平。
Perioperative d-dimer levels in patients with musculoskeletal tumors.
作者信息
Morii Takeshi, Mochizuki Kazuo, Kotera Masazumi, Imakiire Naoaki, Moriwaki Takahiro, Satomi Kazuhiko
机构信息
Department of Orthopaedic Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa Mitaka, Tokyo 181-8611, Japan.
出版信息
Open Orthop J. 2008 Aug 26;2:130-2. doi: 10.2174/1874325000802010130.
BACKGROUND
D-dimer (DD) levels have been reported as a sensitive but non-specific indicator for deep vein thrombosis (DVT) and pulmonary embolism (PE). Few reports have examined perioperative DD levels in musculoskeletal tumor.
MATERIALS/METHODS: Subjects comprised 77 patients who had undergone oncological resection of musculoskeletal tumor. DD levels were assessed preoperatively and on postoperative days 1 and 7. Multidetector-row computed tomography (MD-CT) was performed to detect DVT/PE for cases with DD level >10.0 microg/ml.
RESULTS
Mean preoperative DD level was 0.84 microg/ml. Significant elevation of postoperative DD levels was confirmed. DD levels were significantly changed by various clinical conditions, such as malignancy, age and prosthetic reconstruction. In 4 of 5 cases with postoperative DD levels >10.0 microg/ml, DVT/PE was detected.
CONCLUSION
Activation of the coagulation system by surgery and heterogeneity of DD levels under various clinical conditions in musculoskeletal tumor patients were suggested.
背景
D-二聚体（DD）水平已被报道为深静脉血栓形成（DVT）和肺栓塞（PE）的敏感但非特异性指标。很少有报告研究肌肉骨骼肿瘤患者围手术期的DD水平。
材料/方法：研究对象包括77例行肌肉骨骼肿瘤肿瘤切除术的患者。术前以及术后第1天和第7天评估DD水平。对DD水平>10.0微克/毫升的病例进行多排螺旋计算机断层扫描（MD-CT）以检测DVT/PE。
结果
术前平均DD水平为0.84微克/毫升。术后DD水平显著升高得到证实。DD水平因各种临床情况而有显著变化，如恶性肿瘤、年龄和假体重建。术后DD水平>10.0微克/毫升的5例患者中有4例检测到DVT/PE。
结论
提示手术可激活凝血系统，且肌肉骨骼肿瘤患者在各种临床情况下DD水平存在异质性。
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