摘要
目的对天津医院一段时间内应用低分子肝素进行术后深静脉血栓形成(deep vein thrombosis,DVT)预防的合理性进行分析评价。方法收集1年内骨科手术病例,根据不同手术类型,将其分为关节置换术、复位内固定术、创伤后脊柱修复术,分别统计其低分子肝素的使用率、给药时间、使用疗程、预防效果。结果术后低分子肝素的使用率为84.0%,创伤后脊柱修复术的使用率为58.5%,低于平均水平。关节置换术、内固定术、创伤后脊柱修复术的术前12 h内给药率分别为7.5%,33.3%,0%,术后12 h内全量给药率分别为87.5%,31.6%,8.3%。关节置换术与内固定术的给药疗程最长超过35 d,预防后DVT发生率为12.4%。结论临床采用药物预防时,给药时间和疗程常不能按指南执行。这是药物预防无法到达预期效果,术后DVT的发生率仍较高的重要原因。
OBJECTIVE To evaluate the rationality of the postoperative DVT prevention with the application of low molecular weight heparin over a period of time. METHODS Cases were collected with orthopedics surgery within a year, divided them into joint replacement, internal fixation and post-traumatic spinal prosthesis. Statistics was done according to the use of LMWH, delivery time, course of treatment and prevention effect. RESULTS Utilization rate of LMWH was 84.0%, post-traumatic spinal prosthesis was 58.5% which was below the average. Preoperative 12 h dosing rate of joint replacement, internal fixation and spina repairation were 7.5%, 33.3% and 0%, respectively. Whole quantity dosing rate 12 h after operation were 87.5%, 31.6%, 8.3%, respectively. Between joint replacement and internal fixation, the course of drug treatment was more than 35 d, the incidence of DVT was 12.4%. CONCLUSION The utilization of LMWH can’t follow the guidelines. This is an important reason why the incidence of postoperative DVT is still high in drug prevention.
出处
《中国现代应用药学》
CAS
CSCD
2014年第4期489-491,共3页
Chinese Journal of Modern Applied Pharmacy
关键词
深静脉血栓
低分子肝素
药物预防
合理性评价
骨科手术
deep venous thrombosis
low molecule weight heparin
drug prophylaxis
rationality evaluate
orthopedics surgery
