低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成的预防效果分析  

The effect of low molecular weight heparin calcium combined with physical therapy on the prevention of lower extremity deep vein thrombosis after hip replacement surgery

作　　者：张秀庆 ZHANG Xiu-qing(Department of Osteoarticular Surgery,Yishui County People's Hospital,Linyi 276400,China)

机构地区：[1]沂水县人民医院骨关节外科,276400

出　　处：《中国实用医药》2025年第3期25-29,共5页China Practical Medicine

摘　　要：目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗。比较两组DVT发生情况、下肢深静脉血流速度、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、Harris评分、生活质量评分。结果治疗组的DVT发生率6.67%低于对照组的24.44%(P<0.05)。治疗组治疗后的下肢深静脉血流速度(19.93±1.66)cm/s比对照组的(17.05±1.37)cm/s更快(P<0.05)。治疗组治疗后的PT(12.93±1.16)s、APTT(34.12±3.08)s、TT(14.47±1.21)s长于对照组的(11.24±0.99)、(30.67±2.73)、(13.54±1.12)s,FIB(2.59±0.22)g/L低于对照组的(3.36±0.30)g/L(P<0.05)。治疗组与对照组治疗前后FBG、2 h PBG水平比较均无差异(P>0.05)。治疗组治疗后的Harris评分(76.39±7.30)分比对照组的(65.81±6.25)分更高(P<0.05)。治疗组治疗后的生活质量评分(71.49±6.81)分比对照组的(60.25±5.69)分更高(P<0.05)。结论对髋关节置换术患者使用低分子肝素钙结合物理疗法,可以通过改善体内的高凝状态促进下肢深静脉的血液循环,从而有效预防DVT,对于恢复髋关节功能、提高患者的生活质量具有重要的作用,值得临床推广。Objective To analyze the effect of low molecular weight heparin calcium combined with physical therapy on the prevention of lower extremity deep vein thrombosis(DVT)after hip replacement surgery.Methods 90 patients undergoing hip replacement surgery were divided into control group and treatment group by lottery method,with 45 cases in each group.The control group received physical therapy,and the treatment group received low molecular weight heparin calcium therapy on the basis of the control group.Both groups were compared in terms of DVT occurrence,blood flow velocity of deep vein in lower extremity,coagulation function index[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT)],blood glucose index[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG)],Harris score,quality of life score.Results The incidence of DVT of 6.67%in the treatment group was lower than 24.44%in the control group(P<0.05).After treatment,the blood flow velocity of deep vein in lower extremity of(19.93±1.66)cm/s in the treatment group was faster than(17.05±1.37)cm/s in the control group(P<0.05).After treatment,the treatment group had PT of(12.93±1.16)s,APTT of(34.12±3.08)s and TT of(14.47±1.21)s,which were longer than(11.24±0.99),(30.67±2.73)and(13.54±1.12)s in the control group;the treatment group had lower FIB of(2.59±0.22)g/L than(3.36±0.30)g/L in the control group(P<0.05).There were no differences in FBG and 2 h PBG levels between the treatment group and the control group before and after treatment(P>0.05).After treatment,the Harris score of(76.39±7.30)points in the treatment group was higher than(65.81±6.25)points in the control group(P<0.05).The quality of life score of(71.49±6.81)points in the treatment group was higher than(60.25±5.69)points in the control group(P<0.05).Conclusion The use of low molecular weight作heparin calcium combined with physical therapy for patients after hip replacement surgery can effectively prevent DVT by improving the hypercoagulab

关 键 词：低分子肝素钙 物理疗法 髋关节置换术 下肢深静脉血栓形成 预防 凝血功能 

分 类 号：R687.4[医药卫生—骨科学]