低分子肝素对老年股骨颈骨折患者围术期下肢静脉血栓的预防作用及风险评估  

Preventive effect and risk of low molecular weight heparin on venous thrombosis of lower extremity in perioperative period of elderly patients with femoral neck fracture

作　　者：刘志伟[1] 孟凡星 叶欣[3] 高嘉琪 勾洋[1] 关岚[1] 王聪[1] 赵斌[1] Liu Zhiwei;Meng Fanxing;Ye Xin;Gao Jiaqi;Gou Yang;Guan Lan;Wang Cong;Zhao Bin(Department of Emergency,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Emergency,Beijing Chinese Medicine Hospital Pinggu Hospital,Beijing 100200,China;Department of Cardiology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院急诊科,北京100035 [2]北京中医医院平谷医院急诊科,北京101200 [3]北京积水潭医院心内科,北京100035

出　　处：《中国医刊》2021年第6期624-626,共3页Chinese Journal of Medicine

基　　金：北京积水潭医院青年人才培养“学科新星”计划项目(XKXX201807)。

摘　　要：目的探讨低分子肝素对老年股骨颈骨折患者围术期下肢静脉血栓的预防作用及风险评估。方法选取2019年7月至2020年1月北京积水潭医院急诊科收治的404例老年股骨颈骨折患者的病例资料进行回顾性分析。按照是否规律预防性应用低分子肝素抗凝分为抗凝组和未抗凝组,其中抗凝组患者222例,未抗凝组患者182例。比较两组患者下肢静脉血栓发生率、手术持续时间及输血比例。结果抗凝组与未抗凝组患者下肢静脉血栓发生率分别为1.35%和4.40%,两组患者下肢静脉血栓发生率比较差异无显著性(χ^(2)=3.499,P=0.061)。抗凝组与未抗凝组患者手术持续时间分别为(0.92±0.34)h和(0.92±0.35)h,两组患者手术持续时间比较差异无显著性(t=0.197,P=0.844)。抗凝组与未抗凝组患者输血比例分别为29.73%及23.63%,两组患者输血比例比较差异无显著性(χ^(2)=1.891,P=0.169)。结论在老年股骨颈骨折患者围术期应用低分子肝素不降低其下肢静脉血栓发生率,同时并不延长手术时间,亦不增加输血比例。Objective To explore the preventive effect and risk of low-molecular-weight heparin in the perioperative period of elderly femoral neck fracture on lower limb venous thrombosis.Method A retrospective analysis of 404 elderly patients with femoral neck fractures in the Emergency Department of Beijing Jishuitan Hospital from July 2019 to January 2020.According to the regularity of theapplication of preventive use of low-molecular-weight heparin anticoagulation,they were divided into anticoagulation group and nonanticoagulation group,including 222 patients in the anticoagulation group and 182 patients in the non-anticoagulation group.The incidence of lower limb venous thrombosis,operation duration and blood transfusion ratio were compared between the two groups.Result The incidence of lower limb venous thrombosis in the anticoagulation group and the non-anticoagulation group was 1.35%and 4.40%,there was no significant difference between the two groups(χ^(2)=3.499,P=0.061).The duration of surgery in the anticoagulation group and the non-anticoagulation group was(0.92±0.34)h and(0.92±0.35)h,and there was no significant difference between the two groups(t=0.197,P=0.844).The proportion of blood transfusion in the anticoagulation group and the non-anticoagulation group was 29.73%and 23.63%,and there was no significant difference between the two groups(χ^(2)=1.891,P=0.169).Conclusion Low molecular weight heparin could not reduce the incidence of venous thrombosis of lower extremities and could not prolong the operation time and could not increase the ratio of blood transfusion in the perioperative period offemoral neck fracture in the elderly.

关 键 词：低分子肝素 老年 股骨颈骨折 围术期 下肢静脉血栓 

分 类 号：R658.3[医药卫生—外科学]