低分子肝素对预防骨盆骨折手术老年患者下肢深静脉血栓最佳用药时间的临床研究  

Optimal time of LMWH application to prevent thromboembolism of pelvic fractures surgery in gerontal patients

作　　者：郑豪芬 杨腾衡 陈其福 邓宇 郑豪侠 王家冠 

机构地区：[1]广西钦州市中医医院骨科,广西钦州535099

出　　处：《实用药物与临床》2014年第10期1277-1279,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨低分子肝素(LMWH)对预防骨盆骨折手术老年患者下肢深静脉血栓的最佳用药时间。方法选取我院骨科收治的骨盆骨折行手术治疗的患者53例,根据术后使用LMWH的时间随机分为6 h组和12 h组。观察两组患者术后出血量,术后1、2、7 d的大腿与小腿周径差值,术后1、3 d的纤维蛋白原与D-二聚体水平,术后1、3 d的凝血功能。结果 12 h组患者出血量明显少于6 h组(P<0.01),术后1、2、7 d的大腿周径差值明显大于6 h组(P<0.05),术后2、7 d的小腿周径差值明显大于6 h组(P<0.05),术后3 d的纤维蛋白原水平明显高于6 h组(P<0.01)。两组患者术后3 d的D-二聚体水平比较差异无统计学意义(P>0.05)。12 h组的APTT、PT和TT水平在术前与术后3 d和6 h组比较差异无统计学意义(P>0.05)。结论骨盆骨折手术老年患者术后6 h使用LMWH能够显著降低术后肢体肿胀,降低深静脉血栓的发生率。Objective To investigate the optimal time of LMWH in preventing thromboembolism of pelvic fractures surgery in gerontal patients. Methods A total of 53 gerontal patients with pelvic fractures surgery were randomly divided into 6 h group（6 hours after surgery） and 12 h group（12 hours after surgery） according to the time of postoperative use of LMWH. Postoperative blood loss,diameter difference of thigh and calf at 1,2,7 d after operation,the levels of fibrinogen and D-dimer,blood coagulation function were recorded at 1,3 d after operation. Results The blood loss of 12 h group was less than that of 6 h group（P〈0. 01）,the thigh diameter difference in 12 h group was significantly greater than that of 6 h group at 1,2,7 d after operation（ P〉0. 05）. The fibrinogen level in 12 h group was obviously higher than that of 6 h group at 3 d after operation（P〈0. 01）. There was no significant difference in Ddimer levels,APTT levels,PT levels and TT levels between the two groups（ P〉0. 05）. Conclusion Patients with pelvic fractures surgery using LMWH 6 h after surgery can significantly reduce postoperative limb swelling and the incidence of deep vein thrombosis.

关 键 词：低分子肝素 骨盆骨折手术 深静脉血栓 

分 类 号：R687.3[医药卫生—骨科学]