Significance of dynamic monitoring of D-dimer levels in predicting deep vein thrombosis afterspinal nerve repair / 中国组织工程研究

ABSTRACT

BACKGROUND:Deep vein thrombosis is a common postoperative complication after spinal surgery in clinical department of neurosurgery anddepartment of orthopedics. Deep vein thrombosis is mostly related to vein intima injury, stasis and activation of blood coagulation factor. Early effective prediction can effectively avoid the adverse effects on the prognosis of patients with deep vein thrombosis. D-dimer used in the prediction of deep venous thrombosis has high sensitivity and specificity, andcan be used as a sensitive predictor for deep vein thrombosis. OBJECTIVE:To explore the relationship between plasma D-dimer mass concentration and deep vein thrombosis after spinal surgery. METHODS:A total of 83 patients treated with spinal surgery colected fromDepartment of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University from April 2014 to August 2015 were retrospectively analyzed. They were divided into two groups according to postoperative plasma D-dimer mass concentrationD-dimer positive group (n=48) and D-dimer negative group (n=35). We monitored D-dimer mass concentration in both groups preoperatively and postoperatively 1, 3, 5, 9 and 14 days, and analyzed the relationship between D-dimer mass concentration and deep vein thrombosis. RESULTS AND CONCLUSION:(1) No significant difference in D-dimer mass concentration was determined between the two groups (P> 0.05). D-dimer mass concentration was significantly higher in the D-dimer positive group than in the D-dimer negative group 1, 3, 5, 9, and 14 days postoperatively (P<0.05). (2) After operation, plasma D-dimer of 28 cases was positive, with persistent increasing. Double lower limb deep vein color Doppler ultrasound demonstrated that seven patients experienced deep vein thrombosis and four patients suffered from pulmonary embolism in D-dimer positive group. There was no deep vein thrombosis and pulmonary embolism in the D-dimer negative group. (3) These results indicate that positive D-dimer concentration of patientsafter spinal surgery suggests the possibility of deep vein thrombosis. If the concentration of D-dimer is persistently high, we should highly alert to the occurrence of deep vein thrombosis.