摘要：

目的：探讨颌面部恶性肿瘤手术前后D-二聚体含量的变化及其临床意义。方法：回顾性分析2017年9月—2019年4月在西安交通大学口腔医院进行手术治疗的176例颌面部恶性肿瘤患者的临床资料，术后参考《口腔颌面部恶性肿瘤治疗指南》疗效判定标准将患者分为治疗有效组（152例）和治疗无效组（24例）。采用酶联免疫吸附法（enzyme linked immunosorbent assay，ELISA）检测并比较两组术前（T0）、术后1 d（T1）、术后3 d（T2）、术后5 d（T3）、术后7 d（T4）时血浆D-二聚体含量的变化。结果：组间不同时间点比较，T0时，治疗有效组血浆D-二聚体含量与治疗无效组差异无统计学意义（P>0.05）；T1~T4时，治疗有效组D-二聚体含量均低于治疗无效组，差异有统计学意义（P<0.05）。组内不同时间点比较，除T0和T4外，治疗有效组D-二聚体含量任意两时间点比较，差异均有统计学意义（P<0.05）；治疗无效组D-二聚体含量任意两时间点比较，差异均有统计学意义（P<0.05）。结论：颌面部恶性肿瘤患者均存在不同程度凝血与纤溶系统异常，术前血浆D-二聚体含量高于正常值，术后1 d其含量升高，而术后3~7 d下降并趋于正常值。监测D-二聚体含量变化可客观反映患者体内肿瘤细胞负荷与病情演变的情况，对评估手术治疗效果具有积极的意义。

关键词: 颌面部恶性肿瘤, 手术前后, D-二聚体, 含量变化, 临床意义

Abstract:

Objective: To investigate the changes and significance of D-dimer content in preoperative and postoperative patients with maxillofacial malignant tumors. Methods: The clinical data of 176 patients with maxillofacial malignant tumors who were operated in Stomatological Hospital of Xi′an Jiaotong University from September 2017 to April 2019 were analyzed retrospectively. The patients were divided into the effective group (152 cases) and the ineffective group (24 cases) according to the criteria of Oral and Maxillofacial Malignant Tumor Treatment Guidelines after operation. The changes of D-dimer content at preoperative (T0), 1 day postoperative (T1), 3 days postoperative (T2), 5 days postoperative (T3) and 7 days postoperative(T4) were detected and compared between the two groups by enzyme-linked immunosorbent assay (ELISA). Results: Comparison of different time points between groups: at T0, the D-dimer content had no significant difference between the effective group and the ineffective group(P>0.05). At T1-T4, the D-dimer content of the effective group was lower than that of the ineffective group(P<0.05). As comparison of different time points in the same group: in addition to T0 and T4, the D-dimer content had significant difference at any two time points in the effective group(P<0.05); the D-dimer content had significant difference at any two time points in the ineffective group (P<0.05). Conclusion: There are different degrees of coagulation and fibrinolysis system abnormalities in the patients with maxillofacial malignant tumors. The D-dimer content in maxillofacial tumor patients is higher than the normal value before operation, and increased at the first day after operation. At 3-7 days after operation, D-dimer content decreased and tended to the normal value. Monitoring the change of D-dimer content can objectively reflect the tumor cell load and disease evolution, which has a positive significance for evaluating operation effect.

Key words: maxillofacial malignant tumors, preoperative and postoperative, D-dimer, content changes, clinical significance

中图分类号: 

• R782