The Value And Significance Of The Perioperative Period For The Screening Of Patients With Pelvic And Lower Extremity Fractures

Objective To investigate the value and significance of deep vein thrombosis in patients with pelvic and lower extremity fractures by D- two polymer and color Doppler flow imaging.Methods 408 patients with lower extremity andpelvic fractures who were scheduled forsurgery between January 2015 and June 2015 in the department of orthopedic traumatology of our hospital were investigated. D-dimer testing and CDFI screening of pre-operation and the first three months after operation were carried out to observe the presence of lower extremity vein thrombosis, image performance, location, degree of angiemphraxis and activity.Results 36 cases suffering from lower extremity deep venous thrombosis(LEDVT)of the 408 patients were detected preoperatively with a detection rate 8.8%(36/408). And single site 20 cases, multiple sites 16 cases, acute thrombosis 24 cases(24/36, 66.7%),subacute thrombosis 8 cases(8/36, 22.2%), mixed phase thrombosis 4 cases(4/36, 11.1%),male 16 cases(16/36,44.4%), female 20 cases(20/36, 55.6%), age≥ 50 years old 26 cases,age <50 years old 10 cases. 169 casesconcomitanted with other diseases preoperatively, and28 cases were detected with DVT and 141 cases were not. 239 cases with no other diseases preoperatively, and 8 cases were detected with DVT and 231 cases were not. The preoperativedetection of DVT involving muscular venous thrombosis 29 cases, involving the posterior tibial veins, popliteal vein or the peroneal veins 15 cases and involving superficial or deep femoral vein 11 cases. The value of D-dimer of all the 36 cases were higher than normal range. All the 36 cases underwent anticoagulation, thrombolysis and filter implantation. The detection rate at the first month postoperatively was 3.4%(14/408), all the14 cases were mixed phase thrombosis. The detection rate at the second month postoperatively was 2.0%(8/408) with mixed phase thrombosis 5 cases and subacute thrombosis 3 cases. The detection rate at the third month postoperatively was 1.2%(5/408)and all the 5 cases were old thrombosis with no mobility of the proximal part. The value ofD-dimer of all the patients declined after surgery, most of which declined to the normal range. There was no cerebral infarction, myocardial infarction or pulmonary embolism occurred preoperatively and within 3 months postoperatively and the total mortality rate was0.Conclusions The clinical value and significance of deep venous thrombosis in patients with pelvic and lower extremity fractures during perioperative period is safe and effective.