BACKGROUND:Diagnosis of deep venous thrombosis has been reported in the literatures, but whether the combination with risk prediction scoring system and a variety of laboratory index increase the diagnosis rate of deep venous thrombosis remains unclear.
OBJECTIVE:To improve the diagnosis sensitivity of traumatic deep venous thrombosis of lower extremity using Wel s scoring system combined D-dimer and fibrin degradation product.
METHODA total of 82 patients with low limb fractures and spine fracture were included in this study, those patients with high risk factors of deep venous thrombosis or with the history of deep venous thrombosis were excluded. After admission, the fol owing indicators of deep venous thrombosis were determined, including
D-dimer, fibrin degradation product, fibrinogenase, prothrombin time, activated partial thrombokinase time, blood platelets count, C-reaction protein, and erythrocyte sedimentation rate. In addition, Doppler ultrasound detection of double lower limbs deep vein was performed, and the results were recorded. According to scoring system of deep venous thrombosis of lower extremity (Wel s scoring system), the patients were assigned into low-risk, middle-risk and high-risk cases.
RESULTS AND CONCLUSION:Doppler ultrasound detection showed that, there were 30 cases in deep venous thrombosis group, and 52 cases in non-deep venous thrombosis. The peak value of D-dimer and fibrin degradation product showed significant differences between the two groups (P<0.05). According to Wel s scoring system, there were 13 low-risk cases, 32 middle-risk cases, and 37 high-risk cases. The diagnosis rate of deep venous thrombosis using D-dimer and fibrin degradation product:positive prediction value for middle-risk deep venous thrombosis was 44.44%and for high-risk deep venous thrombosis was 70.97%. Logistic regression analysis showed that, in the middle-risk and high-risk deep venous thrombosis cases, the Wel s score has a positive correlation with laboratory test and Doppler ultrasound detection of deep venous thrombosis (P<0.05). The score of Wel s scoring system combined D-dimer and fibrin degradation product have clinical significances for the formation of deep venous thrombosis of lower extremity after trauma.

From the status quo of medical and health services in rural areas,there exist the following problems:the insufficient number of clinicians,low quality of clinicians,the imbalance of the professional ranks and titles,and aging.Based on investigation and analysis of the rural community health technicians of Huzhou City,Zhejiang Province,the author put forward the new countermeasures of orientation training clinicians in rural communities according to the rural communities residents new demand for medical and health services.