下肢骨折静脉血栓患者的预防效果及影响因素分析  

Influencing factors of venous thrombosis in patients with lower limb fracture and effect analysis of predictive intervention strategy

作　　者：刘军[1] 刘峄 闫楚奇 朱耿耀 王海峡 LIU Jun;LIU Yi;YAN Chu-qi;ZHU Geng-yao;WANG Hai-xia(Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州市中心医院

出　　处：《创伤外科杂志》2020年第1期65-68,共4页Journal of Traumatic Surgery

摘　　要：目的观察下肢骨折患者静脉血栓的临床防治效果,并分析其影响因素。方法前瞻性研究2017年1月—2018年1月徐圳市中心医院收治401例下肢骨折手术患者,按静脉血栓防治策略差异分为对照组(184例,常规静脉血栓防治方法)和预防组(217例,给予早期运动训练+梯度压力弹力袜+药物防治等预见性防治措施)。比较两组静脉血栓发生率和血清活化凝血活酶时间(APTT)、纤维蛋白降解产物(FDP)差异,并分析下肢深静脉血栓发生率在人口学指标、凝血指标、病史上的分布差异。结果干预后,预防组的静脉血栓发生率(5.53%)显著低于对照组的静脉血栓发生率(22.28%,P<0.05),预防组的APTT(31.2±5.2)s显著低于对照组(37.3±6.3)s(P<0.05),预防组FDP(4.6±2.1)μg/mL显著高于对照组(3.4±1.8)μg/mL(P<0.05);下肢深静脉血栓发生率在年龄、凝血指标(APTT、FDP)异常及病史(深静脉血栓史、静脉曲张史)上分布存在差异性,年龄越高、凝血指标异常、有深静脉血栓史及有静脉曲张史的患者下肢深静脉血栓发生率越高(P<0.05)。结论预见性防治策略可有效改善下肢骨折患者静脉血栓相关疗效性指标,从而降低下肢骨折患者静脉血栓的发生率,而年龄越高、凝血指标异常、有深静脉血栓史及有静脉曲张史会对预见性防治效果产生影响,应高度关注。Objective To observe the clinical prevention and treatment effect of venous thrombosis in patients with lower extremity fracture and analyze the influencing factors.Methods According to the difference of clinical prevention and treatment plan,401 patients treated from Jan.2017-Jan.2018 were divided into two groups:routine prevention and treatment group(184 cases,routine prevention and treatment of venous thrombus)and predictive prevention and treatment group(217 cases,given early exercise training+gradient pressure elastic socks+drug prevention and control and other predictive prevention and treatment measures).The incidence of venous thrombus,serum activated thromboplastin time(APTT),fibrin degradation products(FDP)were compared between the two groups.The difference of FDP and the distribution of DVT in demography,coagulation and history were analyzed.Results The incidence of venous thrombosis in predictive group(5.53%)was significantly lower than that in routine group(22.28%,P<0.05);APTT in the predictive group was longer than that in the routine group(P<0.05),and the level of FDP in predictive group was higher than that in routine group(P<0.05).The incidence of thrombosis was different in age,coagulation index(APTT,FDP)abnormality and history(deep vein thrombosis,varicose vein history).The higher the age,coagulation index abnormality,deep vein thrombosis history and varicose vein history was,the higher the incidence of deep vein thrombosis was in lower extremity(P<0.05).Conclusion Predictive prevention and treatment strategies can effectively improve the efficacy of venous thrombosis in patients with lower extremity fractures,thereby reducing the incidence of venous thrombosis in patients with lower extremity fractures.Elder age,higher abnormal coagulation parameters,history of deep venous thrombosis and history of varicose veins may have an impact on predictive prevention and treatment,which should be highly concerned.

关 键 词：下肢骨折 静脉血栓 预防 影响因素 

分 类 号：R683.42[医药卫生—骨科学]