利伐沙班与低分子肝素钙在老年股骨转子间骨折InterTan系统固定围术期隐性失血的研究  

The study between rivaroxaban and low molecular weight heparin calium in perioperative hidden blood loss of elderly patients intertrochanteric fracture used InterTan system fixation

作　　者：王军[1] 杜文波[1] Wang Jun;DuWenbo(Heze Medical College,Heze,Shandong,274000,China)

机构地区：[1]菏泽医学专科学校

出　　处：《当代医学》2019年第20期86-88,共3页Contemporary Medicine

摘　　要：目的探讨利伐沙班和低分子肝素钙应用在老年股骨转子间骨折InterTan系统固定围术期对隐性失血的影响。方法收集在2015年1月至2017年12月于本院行InterTan系统固定的股骨转子间骨折病例88例,依据围术期选用抗凝药分为利伐沙班组(50例)和低分子肝素钙组(38例),统计分析两组在显性失血量、隐性失血量、术前Hct、Hb、术后第1天、第3天、第7天Hb下降值指标。结果两组围术期在显性失血量、术前、术后第1天隐性失血量相比差异无统计学意义;利伐沙班组术后第3天、第7天隐性失血量少于低分子肝素钙组,差异有统计学意义(P<0.05)。利伐沙班组较低分子肝素钙组Hb在术后第1天、第3天下降明显(P<0.05);术后第7天两组Hb下降程度差异无统计学意义;两组组内术后第1天、第3天、第7天Hb下降程度相比差异无统计学意义。结论InterTan系统在老年股骨转子间骨折治疗的围术期应用利伐沙班抗凝隐性失血量较低分子肝素钙低,特别是减少术后3~7d的隐性失血,术后Hb下降程度并不能真实反映隐性失血量,应格外关注。Objective To investigate the impact of rivaroxaban and low molecular weight heparin calcium in perioperative hidden blood loss of elderly patients intertrochanteric fracture used InterTan system fixation. Methods 88 patients with intertrochanteric fractures were collected from January 2015 to December 2017 in our hospital. Divided rivaroxaban group (n=50) and low molecular weight heparin group (n=38) according to the perioperative selection of anticoagulants. Statistical analysis of two groups in the dominant blood loss, hidden blood loss, preoperative Hct and Hb, decreased value of Hb in postoperative 1st, 3rd and 7th day. Results There was no significant difference between the two groups in the dominant blood loss, hidden blood loss in preoperative and postoperative 1st day . The rivaroxaban group less than the low molecular weight heparin calcium group in the hidden blood loss of postoperative 3rd and 7th day, the difference was statistically significant (P<0.05). The rivaroxaban group decreased significantly in the decreased value of Hb in postoperative 1st and 3rd day (P<0.05). There was no significant difference between the two groups in decreased value of Hb on the postoperative 7th day. Intra group comparison, the decreased value of Hb on postoperative 1st, 3rd and 7th day was no significant difference. Conclusion During the perioperative period of elderly patients with intertrochanteric fractures used InterTan system, the hidden blood loss in the rivaroxaban group is lower than the low molecular weight heparin group. In particular, the hidden blood loss decreased obviously in postoperative 3rd to 7rd day. Special attention should be paid to that, the decreased value of Hb is no real reflection of the hidden blood loss.

关 键 词：利伐沙班 低分子肝素钙 隐性失血 INTERTAN 股骨转子间骨折 

分 类 号：R687.3[医药卫生—骨科学]