摘要
目的探讨低分子肝素(LMWH)与间歇充气加压装置(IPC)预防髋关节周围骨折术后深静脉血栓形成(DVT)的临床疗效和安全性。方法 2008年7月至2010年10月,根据病例入选标准选择髋关节周围骨折手术患者126例,分成2组。其中抗凝预防组64例,联合采用基本预防、物理预防与药物预防;对照组62例,除采用基本预防措施外,未用物理预防与药物预防。观察指标:(1)围手术期患者出血量;(2)术后血小板计数变化情况;(3)脑出血、硬膜外血肿出现的神经症状;(4)术前及术后双下肢彩色多普勒检查结果;(5)双下肢肿胀、疼痛等症状。结果抗凝预防组DVT共8例(12·50%),对照组DVT共21例(33·87%),两组DVT发生率差异有统计学意义(P<0·05)。两组患者围手术期出血量及术后血小板计数,差异无统计学意义(P>0·05)。结论髋关节周围骨折术后DVT的发生率高(33·87%),联合应用LMWH和IPC能有效降低髋关节周围骨折术后DVT发生率,并发症少,在预防髋关节周围骨折术后DVT有重要的临床意义。
Objective To study the postoperative deep vein thrombosis （DVT） incidence in patients with hip fractures, and investigate the efficacy and safety on prevention of deep venous thrombosis by using low-molecular-weight heparin （LMWH） incombination with intermittent pneumatic compression （IPC）. Methods From July 2008 to October 2010, 126 patients with hip fracture were selected according to inclusion criteria. Surgical patients were divided into two groups, 64 cases were in anticoagulant preventive group, using primary prevention, physical prevention and drug prevention; 62 cases of control group used primary prevention only. The outcomes were measured as follows ： （ 1 ） the amount of perioperative bleeding; （2） changes in platelet counts after surgery; （3）the neurological symptoms caused by cerebral hemorrhage or epidural hematoma; （4）preoperative and postoperative color Doppler findings in both lower extremities; （5） swelling, pain and other symptoms in both lower extremities. Results There were eight patients with DVT in the anticoagulant preventive group （ 12. 50% ）, and there were 21 patients with DVT in the control group （33.87%）. The difference of DVT incidence between the two groups was statistically significant （ P 〈 0. 05 ）. But the difference was not statistically significant inperioperative blood loss and postoperative platelet count （P 〉 0. 05）. Conclusions The incidence of DVT was higher （33.87%） after hip fractures. Combination of LMWH and IPC can reduce the incidence of postoperative DVT in the hip fractures with fewer complications. The prevention of DVT after hip fractures has important clinical significance.
出处
《中华关节外科杂志（电子版）》
CAS
2011年第2期3-6,共4页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
佛山市医学类科技攻关项目(201008177)
关键词
肝素
低分子量
静脉血栓形成
髋部骨折
外科手术
Heparin, low-molecular-weight
Venous thrombosis
Hip fractures
Surgicalprocedures, Operative
