| ABSTRACT [Abstract]Objective To investigate the predictive value of combined examination of hemostatic and fibrinolytic indexes for deep venous thrombosis(DVT)after proximal femoral nail anti-rotation(PFNA)in elderly patients with femoral intertrochanteric fracture.Methods The clinical data of 80 elderly patients with femoral intertrochanteric fracture underwent PFNA in the First Hospital of Tianshui from April 2019 to April 2023 were analyzed by retrospective case control method.80 patients included 26 males and 54 females,and the age of patients ranged from 60 to 85 years old,with an average of(76.4±5.6)year-old.Patients were divided into DVT group(n=29)and non-DVT group(n=51)according to the presence or absence of DVT after PFNA.The prothrombin time(PT),activated partial prothrombin time(APTT),thrombin time(TT),plasma fibrinogen(FIB),plasma thrombin-antithrombinⅢcomplex(TAT),and D-dimer(D-D)levels in both groups were compared immediately,3d and 7d after PFNA.Correlation of plasma FIB,TAT and D-D in DVT group was verified by Pearson correlation analysis.Multivariate Logistic regression analysis was used to analyze the relationship among hemostatic and fibrinolytic indexes and DVT after PFNA.Then the predictive value of PT,APTT,TT,FIB,TAT and D-D for DVT in elderly patients with femoral intertrochanteric fracture after PFNA was determined by the area under the receiver operating characteristic(ROC).Results：DVT group immediately, 3, 7 Plasma FIB [(4.68 ± 1.77) g / L, (6.73 ± 2.02) g / L, (8.81 ± 2.86) g / l], Tat [(10.64 ± 2.30) μ g / L, (12.88 ± 3.45) μ g / L, (14.96 ± 4.87) μ g / l], D-dimer [(635.00 ± 100.88) μ g / L, (720.02 ± 168.09) μ g / L, (810.47 ± 170.19) μ g / l], levels of plasma FIB [(4.68 ± 1.77), (6.73 ± 2.02 ± 2.02), (8.81 ± 2.86 ± 2.86), Tat [(10.64 ± 2 ± 2.30), (12.88 ± 3.45 ± 3.45 ± 3.45), (14.46 ± 0.47) g / L, (3.55 ± 0.52) g / L, (3.67 ± 0.48) g / l], Tat [(8.58 ± 3.37) μ g / L, (8.69 ± 3.48) g / L] ）50) μ g / L, D-dimer [(588.36 ± 96.68) μ g / L, (589.58 ± 96.45) μ g / L, (591.11 ± 95.50) μ g / l] (P < 0.05 or 0.01)..FIB was positively correlated with D-D(r=0.428,0.523,P<0.05),FIB was positively correlated with TAT(r=0.517,0.411,P<0.05);TAT was positively correlated with D-D(r=0.602,0.596,P<0.05);FIB,TAT,and D-D levels were significantly correlated with DVT in elderly patients after PFNA(OR=3.252,1.461,3.830,P<0.05 or P<0.01).The predictive value of combined detection of PT,APTT,TT,FIB,TAT and D-D for DVT in elderly IFF patients after PFNA was significantly better than that of single detection of each index(P<0.01).Conclusion The combined detection of PT,APTT,TT,FIB,TAT and D-D has a high predictive value for DVT in elderly patients with femoral intertrochanteric fracture after PFNA,which is of vital importance in the early diagnosis of DVT and early prevention of pulmonary embolism and other serious complications. |
