目的:分析血浆D-二聚体水平与变化率对于老年骨科术后患者静脉血栓形成预测价值.方法:选择2015年1月—2017年12月我院老年骨科术后患者250例,入组患者均在手术前与手术后,给予免疫比浊法检测血浆D-二聚体水平,采用酶联免疫吸附法检测血清肿瘤坏死因子-α(TNF-α)与C反应蛋白(CRP)水平.依据患者住院期间是否发生静脉血栓分为非血栓形成组(198例)与血栓形成组(52例),比较两组患者血浆D-二聚体水平与变化率、TNF-α、CRP水平差异.采用受试者工作特征曲线(AUC)分析血浆D-二聚体与变化率及TNF-α、CRP水平对老年骨科术后患者静脉血栓形成的诊断价值.结果:血栓形成组患者血浆D-二聚体、血清TNF-α、CRP水平较非血栓形成组患者略升高,但两组比较差异无统计学意义(P>0.05),但两组患者血浆D-二聚体水平变化率差异具有统计学意义(P<0.05).受试者工作特征曲线分析血浆D-二聚体水平变化率对术后合并血栓的诊断价值,其灵敏度为81.71％,特异度为89.45％.结论:血浆D-二聚体水平变化率对于老年骨科术后合并静脉血栓形成患者具有较好诊断价值.

Objective:To investigate the effect of preoperative application of anticoagulant drugs on spinal fracture. Methods:160 cases of pa-tients undergoing spinal fracture surgery were selected and randomly divided into observation group and control group, 80 cases in each group. The pa-tients in observation group accepted 10mg/d rivaroxaban until 12 h pre-operation, and those in control group did not adopt any anticoagulant drugs. After operation, all patients accepted rivaroxaban for one month, and the clinic effects between the two groups were compared. Results:There were no significant differences of operative time and venous thrombus embolism (VTE) incidence between the two groups ( P >0. 05);The intraoperative blood loss and postoperative drainage volume of patients undergoing internal fixation of fracture in observation group was higher than those in control group ( P <0. 05). Conclusions:Preoperative application of rivaroxaban to patients undergoing spinal fracture surgery can increase the risk of sur-gery with mounting intraoperative blood loss and postoperative drainage volume, but cannot reduce the incidence of VTE. It is unnecessary to use pre-operative anticoagulant drugs treatment for spinal fracture surgery.

目的:探讨舒适护理对妇科腹腔镜手术患者术后的并发症的影响。方法:将56例妇科腹腔镜手术患者随机分为观察组26例和对照组30例,观察组给予舒适护理,对照组给予常规护理,比较分析两组术后对并发症的认知程度及并发症发生情况。结果:观察组对并发症认知程度高于对照组(P<0.05),并发症(穿刺口出血、肠道损伤和下肢静脉血栓形成)发生率和痊愈时间低于对照组(P<0.05)。结论:舒适护理可有效降低妇科腹腔镜手术患者术后并发症,促进患者早日痊愈。