同期行深静脉滤网置入术在下肢闭合骨折合并深静脉血栓患者中的可行性  

Feasibility of synchronous deep vein filter implantation in patients with lower extremity closed fracture and deep vein thrombosis

作　　者：王辞山 孟红亚 柴雷子[1] 万德余[1] 石亿[2] Wang Cishan;Meng Hongya;Chai Leizi;Wang Deyu;Shi Yi(Department of Trauma Orthopedics,the People's Hospital of Bozhou,Bozhou 236800,China;Department of Vascular Surgery,the People's Hospital of Bozhou,Bozhou 236800,China)

机构地区：[1]亳州市人民医院创伤骨科,安徽亳州236800 [2]亳州市人民医院血管外科,安徽亳州236800

出　　处：《血管与腔内血管外科杂志》2022年第10期1249-1253,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨同期行深静脉滤网置入术在下肢闭合骨折合并深静脉血栓(DVT)患者中的可行性。方法收集2019年1月至2021年12月亳州市人民医院收治的74例下肢闭合骨折合并DVT患者的临床资料,根据手术时机的不同将其分为分期组(n=37,常规分期行深静脉滤网置入术)和同期组(n=37,同期行深静脉滤网置入术)。比较两组患者术前、术后3 d凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)]及炎性反应指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平的变化情况。出院前观察两组患者骨折患肢疼痛程度与DVT患肢肿胀程度,统计两组患者的住院时间与并发症发生情况。术后1个月比较两组患者患肢恢复水平[美国足踝外科协会(AOFAS)踝-后足评分、Lane-Sandhu骨折生长评分]。结果手术前后两组患者各项凝血功能指标比较,差异均无统计学意义(P>0.05);术后,两组患者APTT、PT、TT均长于本组术前,FIB水平均低于本组术前,差异均有统计学意义(P<0.05)。手术前后,两组患者各项炎性反应指标比较,差异均无统计学意义(P>0.05);术后,两组患者CRP、TNF-α、IL-6水平均低于本组术前,差异均有统计学意义(P<0.05)。两组患者肺栓塞、术后仍有栓塞、切口感染发生率比较,差异均无统计学意义(P>0.05)。两组患者术后VAS评分、肿胀程度比较,差异均无统计学意义(P>0.05);同期组患者住院时间短于分期组患者,差异有统计学意义(P<0.05)。术后1个月,两组患者AOFAS、Lane-Sandhu骨折生长评分比较,差异均无统计学意义(P>0.05)。结论同期行深静脉滤网置入术不会对下肢闭合骨折合并DVT患者的疗效造成不良影响,且不会导致骨折复位内固定术与深静脉滤网置入术安全性下降,具有临床可行性。Objective To investigate the feasibility of synchronous deep vein filter implantation in patients with lower extremity closed fracture and deep vein thrombosis(DVT).Method Data of 74 patients with lower extremity closed fracture complicated with DVT who were treated in the People's Hospital of Bozhou from January 2019 to December 2021 were selected and divided into staging group(n=37,received conventional stages of deep vein filter implantation)and synchronous group(n=37,received synchronous deep vein filter implantation)according to the period of surgery.The levels of coagulation function indexes[activated partial thrombin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)]and inflammatory indexes[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]before and 3 days after surgery were compared in two groups.Before discharge,the pain degree of fracture extremity and swelling degree of DVT extremity in the two groups were observed,the length of hospital stay and complications in the two groups were counted.The extremity recovery[scores of American Association of Foot and Ankle Surgery(AOFAS)ankle-posterior foot,and Lane-Sandhu fracture growth]in two groups were observed 1 month after surgery.Result There were no significant differences in coagulation function indexes between the two groups before and after surgery(P>0.05).After surgery,the APTT,PT and TT in two groups were higher,FIB level was lower than those before surgery(P<0.05).There were no statistically significant differences in inflammatory indexes between two groups before and after surgery(P>0.05).The CRP,TNF-αand IL-6 level in two groups after surgery were lower than those before surgery(P<0.05).There were no significant differences in the incidence of pulmonary embolism,postoperative still embolism and incision infection between the two groups(P>0.05).There were no significant differences in the degree of postoperative VAS scores and swelling degree between two groups(P>0.05).The length of hospital stay in the

关 键 词：闭合型骨折 深静脉血栓 深静脉滤网置入术 同期手术 

分 类 号：R543[医药卫生—心血管疾病]