CAJ | 학술논문

目的：动态监测D-二聚体水平，探讨其在产后大出血患者临床诊疗中的意义。方法：对19例产后大出血患者连续监测产前、产后1h、2h、4h、8h、24h的血浆D-二聚体、PT、APTT、PLT等指标，了解其峰值水平和持续时间，以及峰值下降的变化趋势。以患者产前PT、APTT、PLT、D-二聚体的平均值为对照组，产后大出血后连续监测PT、APTT、PLT、D-二聚体的平均值为观察组，进行结果分析。结果：动态观察组D-二聚体的浓度最先升高，自产后1h开始明显高于对照组（P＜0.01），4h达到峰值，随着治疗逐渐下降，但8h、24h仍明显高于对照组（P＜0.01），且其变化趋势最敏感；随后PLT下降及APPT、PT升高，其变化趋势、敏感性相对较差。结论：动态监测D-二聚体的水平变化,可以作为产后大出血诊疗时评价疗效及判断预后的较好指标。
목적：동태감측D-이취체수평，탐토기재산후대출혈환자림상진료중적의의。방법：대19례산후대출혈환자련속감측산전、산후1h、2h、4h、8h、24h적혈장D-이취체、PT、APTT、PLT등지표，료해기봉치수평화지속시간，이급봉치하강적변화추세。이환자산전PT、APTT、PLT、D-이취체적평균치위대조조，산후대출혈후련속감측PT、APTT、PLT、D-이취체적평균치위관찰조，진행결과분석。결과：동태관찰조D-이취체적농도최선승고，자산후1h개시명현고우대조조（P＜0.01），4h체도봉치，수착치료축점하강，단8h、24h잉명현고우대조조（P＜0.01），차기변화추세최민감；수후PLT하강급APPT、PT승고，기변화추세、민감성상대교차。결론：동태감측D-이취체적수평변화,가이작위산후대출혈진료시평개료효급판단예후적교호지표。
Objective: To detect the level of D-dimer dynamically and discuss its significance during the treat-ment of postpartum hemorrhage.Methods: keep detecting D-dimer,PT,APTT,PLT and other indexes of plasma of 19 cases of patients of postpartum hemorrhage in 1h,2h,4h,8h and 24h antepartum and postpartum,learn its peak level , time of duration,and the trend of peak decline. Take the average value of PT,APTT,PLT and D-dimer in ante par-tum as control group,and the average value of PT,APTT,PLT and D-dimer detected continuously in postpartum as the observation group and analyze the results.Results: the concentration of D-dimer of the dynamic observation group goes up firstly,and it becomes obviously higher than that of control group since the first hour postpartum (P<0.01) ,it reaches the peak in 4h and then declines gradually with the going on of the treatment,but it is still greatly higher than control group in 8h and 24h (P<0.01),and it changing trend is most sensitive. And then PLT declines and APPT,PT goes up,the changing trend and sensitivity is relatively weak.Conclusion: detecting the level of D-dimer dynamically can be a good direction for the evaluation of effect and the judgement of prognostic.