摘要
为探讨低分子量肝素(LMWH)在预防老年性髋骨骨折后下肢深静脉血栓(DVT)中的作用及血浆凝血因子的动态变化和临床意义。将88例非手术治疗的新鲜髋骨骨折患者随机分为对照组及预防组。预防组44例给LMWH共14天,对照组不用LMWH。观察此期间两组DVT形成的发生率、血浆部分凝血活酶时间(APIT)、凝血酶原时间(PT)、凝血酶时间(TT)、活化凝血因子X(FXa)活性、纤维蛋白原(Fib)及D-二聚体(D-D)含量的变化。结果两组DVT发生率比较预防组为4.54%(2/44),对照组为43.19%(19/44),有显著性差异(P<0.01),FXa活性、Fib含量、D-D的含量预防组较对照组有显著下降(P<0.01)。APTT、TT在两组间有统计学意义(P<0.05)。预防组未发现重要脏器及骨折处明显出血,未发现过敏及血小板计数异常等明显的不良反应。表明在老年髋骨骨折非手术治疗过程中,凝血指标测定可为肝素预防下肢深静脉血栓形成的发生提供依据。
The objective of the paper is to study the therapeutic effect of low molecular weight heparin (LMWH) on the prevention of lower-limb deep venous thrombosis (DVT) in senile femoral fracture (SFF) and the dynamic changes and clinical significance of plasma coagulation factors. Eighty-eight cases of fresh SFF treated non-surgically were randomly divided into two groups (44 cases each): the prevented treated by LMWH for 14 days and the control not receiving LMWH; the DVT incidences, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), activated coagulation factor activity X (FXa), fibrinogen (Fib) and the changes of D-Dimer (D-D) level of the two groups were observed during this period. The results showed that the DVT incidences of the prevented and the control were 4.54 % (2/44) and 43.19 % (19/44), respectively with a significant difference (P < 0.01); the levels of FXa, Fib and D-D in the prevented decreased significantly compared with the ones of the control (P < 0.01); there was a statistical significance between the two groups in APTT and TT; no obvious bad reactions occurred in the prevented group, including the bleeding in the important organs and the fractured site, allergic reaction and abnormal platelet count, etc, suggesting that during the non-operative treatment of SFF, the detection of coagulation indices could offer a basis for the prevention of DVT by LMWH.
出处
《中医正骨》
2005年第9期13-14,共2页
The Journal of Traditional Chinese Orthopedics and Traumatology
关键词
髋骨骨折/并发症
下肢静脉血栓/治疗
肝素/治疗应用
凝血因子
临床研究
femoral fracture/complications, lower-limb venous thrombosis/treatment, heparin/therapeutic application, coagulation factor, clinical study
