摘要
目的探讨术前抗凝治疗对高龄下肢骨折合并深静脉血栓(DVT)患者手术安全性的影响。方法回顾性分析86例高龄下肢骨折合并DVT患者的临床资料。术前使用低分子量肝素钙抗凝5~7 d,复查下肢静脉彩超,提示血栓消失(n=29)或血栓部分机化(n=57),再进行手术治疗。观察患者围术期出血并发症及急性肺栓塞的发生情况。结果所有患者均顺利完成手术,在围术期均未出现严重出血并发症(如脑出血、消化道出血、术后切口大渗血等),也没有出现急性肺栓塞。结论对于高龄下肢骨折合并DVT患者,术前进行抗凝治疗5~7天后,复查彩超提示血栓消失或部分机化时,行骨科手术治疗安全性较高。
Objective To explore the effect of preoperative anticoagulation therapy on the safety of operation in elderly patients with lower extremity fracture complicated with deep venous thrombosis(DVT).Methods The clinical data of 86 elderly patients with lower extremity fracture complicated with DVT were analyzed retrospectively.Preoperative anticoagulation with low-molecular-weight heparin calcium was performed for 5 to 7 days,lower extremity vein re-examination by Color ultrasound revealed absence of thrombus in 29 cases and partial thrombus organization in 59 cases,and all of them received surgical treatment.The incidence of perioperative bleeding-related complications and acute pulmonary embolism was observed in the patients.Results All patients completed the operation successfully,and neither serious perioperative bleeding-related complications(such as cerebral hemorrhage,gastrointestinal hemorrhage,postoperative incision massive bleeding,etc.)nor acute pulmonary embolism occurred.Conclusions For elderly patients with lower extremity fracture complicated with DVT who undergo anticoagulation treatment for 5 to 7 days preoperatively,orthopedic operation might achieve higher therapeutic safety in the context of absence of thrombus or partial thrombus organization identified by Color ultrasound re-examination.
作者
李德剑
赵凤
杨小平
黄永森
李洲
LI De-jian;ZHAO Feng;YANG Xiao-ping;HUANG Yong-sen;LI Zhou(Department of Internal Medicine,Yulin Orthopaedic Hospital of Integrated Chinese and Western Medicine,Yulin 537000,China)
出处
《广西医学》
CAS
2020年第1期41-43,共3页
Guangxi Medical Journal
关键词
下肢骨折
下肢深静脉血栓
高龄
低分子量肝素钙
抗凝治疗
并发症
手术治疗
Lower extremity fracture
Deep venous thrombosis of lower extremity
Advanced age
Low-molecular-weight heparin calcium
Anticoagulation treatment
Complications
Surgical treatment
