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凝血酶原、活化部分凝血活酶及凝血酶时间在胫骨骨折手术后早期康复中的意义

Significance of prothrombin, activated partial thromboplastin, and thrombin times in early rehabilitation after tibial fracture surgery.

作者信息

Zhang Min

机构信息

Department of Trauma Orthopedics, The Fourth Hospital of Wuhan No. 473 Hanzheng Street, Qiaokou District, Wuhan 430000, Hubei, China.

出版信息

Am J Transl Res. 2024 Sep 15;16(9):4894-4902. doi: 10.62347/XKLL3245. eCollection 2024.

DOI:10.62347/XKLL3245
PMID:39398598
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11470317/
Abstract

OBJECTIVE

To assess the role of prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) in guiding early rehabilitation following tibial fracture surgery.

METHODS

A retrospective analysis was conducted on 168 patients treated for tibial fractures from May 2020 to May 2022. Patients were divided into good and poor rehabilitation groups based on treatment outcomes. Data on age, gender, BMI, Schatzker classification, operation time, blood loss, PT, APTT, and TT were collected for univariate analysis. ROC curve analysis determined optimal cut-off values, followed by multivariable logistic regression to identify independent risk factors. A nomogram prediction model was then constructed.

RESULTS

Independent risk factors for early recovery included age ≥45 years, Schatzker type III, operation time ≥99.5 minutes, APTT≥28.5 seconds, and TT≥13.5 seconds. The nomogram model demonstrated high prediction accuracy with a C-index of 0.980.

CONCLUSION

Prolonged APTT, extended TT, longer operation time, and higher Schatzker classification were identified as independent risk factors influencing early recovery post-surgery. A logistic regression-based prediction model was developed, facilitating the design of personalized rehabilitation training programs to improve patient outcomes.

摘要

目的

评估凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和凝血酶时间(TT)在胫骨骨折手术后指导早期康复中的作用。

方法

对2020年5月至2022年5月期间接受治疗的168例胫骨骨折患者进行回顾性分析。根据治疗结果将患者分为康复良好组和康复不良组。收集年龄、性别、体重指数、Schatzker分类、手术时间、失血量、PT、APTT和TT的数据进行单因素分析。ROC曲线分析确定最佳截断值,然后进行多变量逻辑回归以识别独立危险因素。随后构建列线图预测模型。

结果

早期恢复的独立危险因素包括年龄≥45岁、Schatzker III型、手术时间≥99.5分钟、APTT≥28.5秒和TT≥13.5秒。列线图模型显示出较高的预测准确性,C指数为0.980。

结论

APTT延长、TT延长、手术时间延长和Schatzker分类较高被确定为影响术后早期恢复的独立危险因素。开发了基于逻辑回归的预测模型,有助于设计个性化康复训练方案以改善患者预后。