Early diagnosis of lower limb deep vein thrombosis after total hip arthroplasty

YAN Pei-yun; SONG Chao-ji; MIAO Sheng-long; WANG Dong; BI Hu

doi:10.3969/j.issn.2095-252X.2013.08.005

Abstract： Objective To investigate the diagnostic values and their respective sensitivities and specificities of D-dimer ( DD ), plasma fibrinogen ( FIB ) and fibrin degradation products ( FDP ) in the development of lower limb deep vein thrombosis ( DVT ) for the patients treated with total hip arthroplasty ( THA ) during the perioperative period. Methods From June 2008 to June 2012, 168 patients were treated with THA in our Department. The plasma DD, FIB and FDP were tested in all the patients before the operation and at the 1st, 3rd and 7th days after the operation. The color Doppler ultrasound blood flow detector was used to examine the development of lower limb DVT in these patients before the operation and at the 3rd and 7th days after the operation. According to the test results of the color Doppler ultrasound blood flow detector, the patients were divided into the positive DVT group and the negative DVT group. The diagnostic values and their respective sensitivities and specificities of DD, FIB and FDP were analyzed in the development of DVT after THA. Results After the operation, 32 patients ( 19.1%) developed DVT. In the 3 indicators, the areas under the receiver operating characteristic ( ROC ) curve were 81.8%for DD ( P=0.002 ) and 68.4% ( P=0.009 ) for FDP, and for FIB the area was only 56.3% ( P=0.31 ). Conclusions There are diagnostic values for DD and FDP in the development of DVT after THA. However, for FIB the diagnostic value is lower. When the DD and FDP are tested promptly after the operation, DVT can be diagnosed without delay, and pulmonary thromboembolism ( PT ) can be avoided.