低分子肝素预防骨盆髋臼骨折后下肢深静脉血栓的临床研究  

Clinical study of low molecular weight heparin in preventing deep venous thrombosis after pelvic and acetabular fractures

作　　者：王海立[1] 孙家元[1] 张弢[1] 刘磊[1] 杨宗酉[1] 李旭[1] 张英泽[1] 

机构地区：[1]河北医科大学第三医院创伤急救中心,石家庄050051

出　　处：《中华实验外科杂志》2016年第8期2054-2056,共3页Chinese Journal of Experimental Surgery

基　　金：河北省食品药品监督管理局2014年度食品药品安全科技项目计划（PT2014059）

摘　　要：目的探讨低分子肝素预防骨盆髋臼骨折后下肢深静脉血栓形成的效果和安全性以及相关因素的影响。方法对我院收治的215例骨盆髋臼骨折患者的临床资料进行回顾性分析，根据是否接受低分子肝素治疗，分为两组：接受低分子预防的抗凝治疗组84例和未接受低分子预防的常规治疗组131例。分析两组双侧下肢深静脉血栓形成以及出血等不良反应发生情况，同时采用多因素非条件Logistic回归分析进行深静脉血栓的危险因素分析。结果共215例患者纳入本研究，抗凝治疗组4例发生下肢深静脉血栓，其发生率为4．76％，常规治疗组发生下肢深静脉血栓20例，发生率为15．26％，抗凝治疗组发生率明显降低，差异有统计学意义（P〈0．05），经Logistic回归分析显示，住院时间与血栓形成不相关，而年龄和合并伤与血栓形成明显相关（P〈0．05）。结论对骨盆髋臼骨折患者，低分子肝素能降低伤后下肢深静脉血栓形成的危险，且使用安全，但使用率偏低。Objective To explore the clinical efficacy of low molecular weight heparin in the pre- vention of deep venous thrombosis after pelvic and acetabular fractures and analyze the related factors. Methods Two hundred and fifteen patients with pelvic and aeetabular fractures admitted were retrospec- tively reviewed. According to whether they received the prophylaxis of low molecular weight heparin, 84 patients were divided into anticoagulant treatment group and 131 were included in routine treatment group. The incidences of the deep vein thrombosis and hemorrhage complications were compared between the two groups. Besides, the related factors were confirmed through logistic regression analysis. Results A total of 215 patients were included in this study. Deep venous thrombosis occurred in 4 patients in the anticoagu- lant therapy group with the incidence of deep vein thrombosis being 4. 76% , and 20 in the routine treat- ment group with the incidence being 15.26% （ P 〈 0. 05 ）. The outcomes of logistic regression analysis showed that deep vein thrombosis was not associated with the length of hospital stay, but age and combined injury were obviously related with deep vein thrombosis （ P 〈 0. 05 ）. Conclusion Low molecular weight heparin can reduce risk of deep venous thrombosis after pelvic and acetahular fracture safely and effectively but without enough and proper medication administration.

关 键 词：低分子肝素 骨盆髋臼骨折 下肢深静脉血栓 

分 类 号：R543.6[医药卫生—心血管疾病]