全髋关节置换术后深静脉血栓的预防和治疗  

Prevention and treatment of deep vein thrombosis after total hip replacement

作　　者：周林[1] 李乃戈[1] 黄体军[1] 罗玥妲[1] 杨小莉[2] 熊继尧[3] 周霞[4] 

机构地区：[1]解放军第37医院药械科,四川雅安625000 [2]解放军第37医院胸骨科,四川雅安625000 [3]重庆医药高等专科学校,重庆400030 [4]雅安市第二人民医院,四川雅安625000

出　　处：《局解手术学杂志》2013年第3期285-287,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨全髋关节置换术后低分子肝素对深静脉血栓的预防效果,比较溶血栓和抗凝治疗对血栓的治疗效果。方法实验组86例全髋关节置换术施以低分子肝素钠腹壁皮下注射,预防下肢深静脉血栓的形成,对照组78例全髋关节置换术后发现血栓才给以尿激酶和肝素钠、华法林处理。结果实验组和对照组在术中、术后的出血量和输血量无显著差异,无统计学意义(P>0.05);实验组术后出现下肢深静脉血栓形成者仅为3例,对照组为14例,两组差异具有统计学意义(P<0.05)。结论全髋关节置换术后使用低分子肝素进行抗凝,可以显著降低下肢深静脉血栓的发生率,具有良好的安全性。Objective Study the prophylaxis effect of low molecular weight heparin on deep venous thrombosis after total hip arthroplasty, and compare the curative effect of thrombolytic and anticoagulant therapy for thrombosis. Methods 86 cases of the experimental group were given abdominal subcutaneous injection with low molecular weight hparin for prevention of lower limb deep venous thrombsis; 78 patients of the control group were treated with urokinase, heparin sodium and warfarin after the thrombi were observed. Results There was no significant difference between the two groups in terms of intraoperative blood loss, postoperative blood loss, and blood transfusion volume （P 〉0.05）. After the surgery, 3 cases of deep vein thrombosis were discovered in the experimental group while there were 14 cases in the control group. The difference between the two groups was significant （ P 〈 0.05 ）. Conclusion Using low molecular weight heparin for anticoagulation after total hip replacement surgery could significantly reduce the incidence of deep vein thrombosis with good safety.

关 键 词：全髋关节置换 深静脉血栓 低分子肝素 抗凝 

分 类 号：R654.4[医药卫生—外科学]