低分子肝素预防下肢骨折患者肺栓塞发生的临床研究  

Clinical observation of low-molecular-weight heparin( LMWH) on preventing pulmonary thromboembolism( PTE) after lower limb fracture

作　　者：王晓波[1] 喻昌利[1] 赵金良[2] 

机构地区：[1]河北联合大学附属医院呼吸内科,河北唐山063000 [2]河北联合大学附属医院急诊科,河北唐山063000

出　　处：《实用药物与临床》2015年第7期872-874,共3页Practical Pharmacy and Clinical Remedies

基　　金：唐山市科技局指令性项目(12140209A-1)

摘　　要：目的观察低分子肝素预防下肢骨折患者肺栓塞的疗效。方法选取2012年1月至2013年1月我院收治的下肢骨折住院患者120例,随机分为低分子肝素组和对照组,每组60例。两组均进行常规治疗,对照组不予特殊干预;低分子肝素组应用低分子肝素预防,按0.1 m L/（kg·d）标准皮下注射,1次/12 h,10∽15 d为1个疗程,给药途径为腹壁皮下脂肪层注射。两组均于住院第2、10天检测全血黏度,比较两组的疗效。结果对照组治疗前血浆黏度（高切全血黏度、低切全血黏度、高切还原黏度、低切还原黏度）分别为5.45±1.32、11.78±3.95、9.56±1.33、26.09±3.38、1.50±0.54,治疗后为0.24±0.38、0.89±0.63、1.06±0.48、3.64±2.01、0.05±0.24;低分子肝素组治疗前分别为5.5±1.6、11.68±4.78、9.20±1.23、26.36±3.71、1.45±0.53,治疗后为0.30±0.17、1.32±0.45、2.89±1.22、4.25±2.05、0.13±0.20。低分子肝素组患者血流变学指标情况均有不同程度好转,全血黏度（低切）、全血还原黏度（高切）和血浆黏度优于对照组,两组比较差异有统计学意义（P〈0.05）。对照组发生肺栓塞1例,低分子肝素组无肺栓塞发生。结论低分子肝素预防骨折患者肺栓塞安全有效。Objective To evaluate the efficacy of low-molecular-weight heparin（ LMWH） on preventing pulmonary thromboembolism（ PTE） after low er limb fracture. Methods 120 cases of hospitalized patients w ith low er limb fracture in our hospital w ere chosen from January 2012 to January 2013,they w ere randomly divided into low molecular heparin group and control group,60 cases in each group. The tw o groups took all routine treatments,no special interventions w as taken on control group. Low molecular heparin group w as given low molecular heparin prevention,0. 1 m L /（ kg·d） abdominal subcutaneous fat layer injection,once every 12 h w ith 10 ∽ 15 d for a period of treatment. Alteration of hemorheology and blood coagulation state w ere measured on the second and 10 th day after the patients admitted to the hospital. Results The high-shear blood viscosity,reduced visiosity and low-shear in control group w ere： 5. 45 ± 1. 32,11. 78 ± 3. 95,9. 56 ± 1. 33,26. 09 ± 3. 38,1. 50 ± 0. 54 before treatment and 0. 24 ± 0. 38,0. 89 ± 0. 63,1. 06 ± 0. 48,3. 64 ± 2. 01,0. 05 ± 0. 24 after treatment the indexes in low molecular heparin group w ere5. 5 ± 1. 6,11. 68 ± 4. 78,9. 20 ± 1. 23,26. 36 ± 3. 71,1. 45 ± 0. 53 before treatment,and 0. 30 ± 0. 17,1. 32 ± 0. 45,2. 89± 1. 22,4. 25 ± 2. 05,0. 13 ± 0. 20 after treatment. The hemorheology of low molecular heparin group w as improved,and the w hole blood viscosity（ low shear）,w hole blood reductive viscosity（ high shear） and plasma viscosity w ere better than those of control group,there w ere significant differences betw een the tw o groups（ P〈0. 05）. One case of pulmonary embolism occured in control group. Conclusion LMWH is effective and safe for the prevention of PTE after low er limb fracture.

关 键 词：骨折 低分子肝素 肺栓塞 全血黏度 

分 类 号：R687.3[医药卫生—骨科学]