Differences and molecular mechanisms of postoperative lower limb limb venous thrombosis formation in elderly patients with hip fractures of different blood types
WANG Yong-chao,SU Qin,LIN Xin
Department of Joint Sports Medicine, the First Affiliated Hospital of Hunan Medical College, Huaihua, Hunan
418000,China
Abstract:
Objective To explore the differences and molecular mechanisms of lower limb venous thrombosis (VTE) formation in elderly patients with hip fractures of different blood types after surgery. Methods 160 patients with intertrochanteric fractures of the femur in our hospital from January 2020 to December 2022 were selected and grouped according to blood type: A-type group of 40 cases, B-type group of 40 cases, ABtype group of 40 cases, and O -type group of 40 cases. All patients underwent closed reduction and intramedullary nail fixation surgery. Compare the incidence of VTE among different blood group groups; compare the changes in thromboelastography (TEG) indicators, D-dimer levels, key coagulation promoting factors, and key anticoagulant factors levels among different blood group groups before and 1 week after surgery. Results Among the 160 patients with intertrochanteric fractures of the femur, 43 had postoperative VTF, with an incidence rate of 26.87%. The incidence of VTE in the O-type group was lower than that in the A-type group,B -type group, and AB -type group (P<0.05).Preoperative R value, K value, aangle, MA value,D-dimer, von willebrand factor (vWF), FV III factor(FV III), tissue factor (TF), tissue factor pathway inhibitor (TFPI), protein C (PC), protein S (PS), and thrombomodulin (TM) were no significant difference (P>0.05); the A-type, B-type, and AB-type groups R-values, TFPI, PC, PS, and TM lower before surgery at 1week, while the K-values, aangle, MA value, D-dimer, vWF, FV III, and TF higher before surgery (P<0.05);the R-value, K-value, aangle, MA value, D-dimer, vWF, FV III, TF, TFPI, PC, PS, and TM compared to before surgery no significant differences (P>0.05); the O-type group R-value, TFPI, PC, PS, and TM higher A-type group, B-type group, and AB type group at 1 week after surgery, while the K-value, aangle, MA value, Ddimer,vWF, FV III, and TF lower A-type group, B-type group, and AB-type group (P<0.05). Conclusion The incidence of postoperative VTE in femoral intertrochanteric fractures is the lowest in type O, and the Rvalue,TFPI, PC, PS, and TM of O-type group higher A-type, B-type, and AB-type groups, while the K-value,aangle, MA value, D -dimer, vWF, FV III, and TF lower A -type, B -type, and AB -type group, and their differences may be closely related to the formation of VTE in patients with different blood types.
