Study Plasma D-dimer Formation In Two Clinical Significance Of Detection And Analysis Of The Process Of Diagnosis And Treatment In Deep Venous Thrombosis Of Lower Extremity

Objective: in our department has been in 119 patients of acute lower extremity angiography or echocardiography examination confirmed the diagnosis of venous thrombosis of the D- dimer in the positive rate of detection and analysis, study the levels of plasma D- dimer expression in acute lower extremity venous thrombosis patients, provide better guidance for early acute pulmonary embolism lower limbs vein thrombi were found; correlation change and thrombus clear plasma in acute lower extremity venous thrombosis thrombolytic treatment process D-dimer content occur, development and evolution, so as to better guide the clinical treatment. Methods: confirmed by venography in our hospital in 2013 May-2014 year in October hospitalized with acute lower extremity deep venous thrombosis in treatment of 119 patients(age 30-50 years, mean age 40.5 ± 2.5 years, including 65 cases of male, female 54 cases, 60 cases of central type, peripheral type thrombus thrombus in 24 cases, mixed thrombus in 35 cases, 28 cases with pulmonary embolism, no pulmonary embolism in 91 cases) of plasma D- dimer content detection, The patients were asked the relevant effects of history and related examination to exclude the tumor, diabetes, atherosclerosis, hyperlipidemia and other factors D- dimer content, first of all to complicated with pulmonary embolism and pulmonary embolism in two groups of patients that were D- dimer content on admission were measured, by comparing the content level and positive analysis of the rate of expression of plasma D- dimer in two definite pulmonary embolism in patients with thrombosis; then according to the site is divided into peripheral type, central type and mixed type of thrombosis in three groups of patients, in three groups of patients were treated with thrombolytic treatment plan: urine kinase 1000000 units of limb static point + low molecular weight heparin subcutaneous injection of 5000 U Q12h+ blood plug the 0.4g static point once a day. For the above three groups of patients in thrombolytic therapy, thrombolytic therapy before 7 days after treatment of plasma D-dimer detection two changes before and after thrombolytic therapy, the plasma D-dimer clear polymer content, at the same time angiography or ultrasound thrombus, clear changes and plasma D- poly changes in body content is not consistent with.Results: acute lower extremity deep venous thrombosis pulmonary embolism patients without D- dimer content of the positive rate of 0.700±0.01mg/L, 74.7% with pulmonary embolism group, two D- dimer content was 2.820±0.01mg/L, the positive rate was 100%, significantly higher than those without pulmonary embolism group, the difference was statistically significant(P <0.05). D- dimer content and the positive rate was not consistent in all types of thrombosis(peripheral D-dimers in 0.638±0.01mg/L, the positive rate was 62.5%; the content of 0.907±0.01mg/L, the positive rate of central type 75%; hybrid 1.39±0.01mg/L, the positive rate was 80%), the difference was statistically significant(P <0.05). The plasma D-dimers in the treatment of thrombolysis sustainable increases or is not reduced, after angiography or ultrasound thrombolysis failure often display, or the presence of pulmonary embolism etc.. The plasma D-dimer in the treatment of thrombolysis decreased rapidly or negative, angiography showed thrombosis disappeared or partial recanalization.Conclusion:1 the plasma D- dimer content in peripheral and central type and mixed type thrombosis was in turn increased, the positive rate was also increased in turn.2 the plasma D- dimer continued to increase body content or not reduce prompt thrombolytic, anticoagulant drugs is insufficient or the presence of active thrombus.3Venous thrombosis in 3 plasma D- dimer levels in two patients with acute venous thrombolytic treatment process changes and angiography or ultrasound showed the evolution of the agreement.4 the exclusion of patient age, tumor, blood glucose, blood lipid and atherosclerosis effect, to have been confirmed by angiography of lower limb venous thrombosis patients, the D-dimer negative, can basically rule out pulmonary embolism; the result is positive, still need for further inspection clearly has no pulmonary embolism.