保守治疗老年髋部骨折下肢深静脉血栓的预防  

Prophylaxis of Deep Venous Thrombosis in Elderly Patients with Hip Fracture Without Hip Replacement

作　　者：齐宝庆[1] 李英[1] 晁爱军[1] 韩宏[1] 王毅[1] 胡佩群[1] 

机构地区：[1]天津市天津医院内科,300211

出　　处：《天津医药》2004年第8期487-489,共3页Tianjin Medical Journal

摘　　要：目的 :观察保守治疗老年髋部骨折患者下肢深静脉血栓形成 (DVT)的发生率及低分子肝素预防其形成的效果和安全性。方法 :120例新鲜髋部骨折患者 ,随机抽取60例干预组给予依诺肝素治疗40mg/d ,共14d ,60例不用依诺肝素 (对照组 )。观察2组DVT的发生率 ,血浆部分凝血活酶时间 (APTT)、凝血酶原时间 (PT)、凝血酶凝固时间 (TT)、活化凝血因子X(FXa)含量及活性、纤维蛋白原 (Fib)含量及D_二聚体 (D_D)含量的变化。结果 :对照组DVT发生率为56 67 %(34/60) ,干预组为3 33 % (2/60) ,差别有统计学意义。2组APTT、PT及TT差别无统计学意义 ,而FXa含量及活性 ,Fib含量及D_D的含量在干预组较对照组下降(P<0 05)。干预组未见明显的不良反应。结论 :在老年髋部骨折保守治疗中应用低分子肝素进行干预 ,可降低DVT的发生率 ,且无明显的不良反应。Objective:To study the incidence of deep venous thrombosis(DVT)in elderly patients with hip fracture without hip replacement,and the validity and safety of prophylaxis with low molecular weight haparin.Methods:One hundred and twenty patients with fresh hip fracture were randomly divided into2groups,60patients in the intervention group were prescribed enoxaparin40mg once a day for14days,and the others in the control group were not given.The activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),concentration and activity of factor Xa(FXa),and concentration of fibfinogen(Fib)and D_dimer(D_D)were observed in two groups.The adverse effect relative to enoxaparin was detected in the same time.Results:The incidence of DVT in the control group was56.67%(34/60)compared to3.33%(2/60)in the intervention group(P<0.01).There was no statistical difference in APTT,PT and TT between two groups(P>0.05).The concentration and activity of FXa,and the concentration of Fib and D_D were lower in the intervention group than that in the control group(P<0.05).The adverse effects such as bleeding was not found in the intervention group.Conclusion:The intervention of low molecular weight haparin can decrease the inˉcidence of DVT in elderly patients with hip fracture without hip replacement.There was no significant adverse effect during the treatment with haparin.

关 键 词：髋骨折 下肢 血栓性静脉炎 老年人 

分 类 号：R683.3[医药卫生—骨科学]