摘要
目的探讨低分子肝素对股骨粗隆间骨折内固定术患者失血量及深静脉血栓形成(DVT)的预防效果。方法选取2019年2月—2021年2月于宁德人民医院行股骨粗隆间骨折内固定术患者86例,按照随机数字表法分为对照组与观察组,各43例。对照组术后进行早期功能康复训练,观察组在对照组基础上予以低分子肝素治疗,持续用药10 d。比较2组失血量、显性失血量、总失血量、凝血功能指标〔凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)〕、血液流变学指标〔血浆黏度(PV)、全血高切黏度(HSV)、全血低切黏度(LSV)〕、术后DVT发生率,并观察2组不良反应发生情况。结果2组失血量、显性失血量及总失血量比较,差异无统计学意义(P>0.05)。术后,观察组PT、APTT长于对照组,D-D、PV、HSV、LSV低于对照组(P<0.05)。观察组术后DVT发生率低于对照组(P<0.05)。观察组皮下注射低分子肝素后不良反应较轻微。结论低分子肝素皮下注射可改善股骨粗隆间骨折内固定术患者凝血功能,维持正常的血液循环,并降低术后DVT发生风险,且未增加失血量,安全可靠。
Objective To discuss the preventive effect of low molecular weight heparin on blood loss and deep venous thrombosis(DVT)in patients with internal fixation of intertrochanteric fracture of femur.Methods A total of 86 cases of patients with internal fixation of intertrochanteric fracture of femur were selected from February 2019 to February 2021 in Ningde People's Hospital,which were randomly divided into control group and observation group,43 cases in each group.Both groups were treated with internal fixation of intertrochanteric fracture of femur.The control group was accepted early functional relicbilit ation training.The observation group was treated with low molecular weight heparin for 10 days after operation.Latent blood loss,explicit blood loss,total blood loss,coagulation function indexes〔prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D)〕,hemorheological indexes〔plasma viscosity(PV),whole blood high shear viscosity(HSV),whole blood low shear viscosity(LSV)〕,incidence of DVT after operation were compared between the two groups,and the incidence of adverse reactions were observed.Results There was no significant difference in latent blood loss,dominant blood loss and total blood loss between the two groups(P>0.05).After operation,PT,APTT in observation group were longer than those in contral group,D-D,PV,HSV and LSV in the observation group were lower than those in the control group(P<0.05).The incidence of DVT in observation group was lower than that in control group(P<0.05).Adverse reactions of observation group after subcutaneous injection of low molecular weight heparin were mild.Conclusion Subcutaneous injection of low molecular weight heparin can improve the coagulation function of patients with internal fixation of intertrochanteric fracture of femur,maintain normal blood circulation and reduce the risk of DVT after operation,and the hidden blood loss is not increased,which is safe and reliable.
作者
胡廷建
章高鹏
郑鸣辉
HU Tingjian;ZHANG Gaopeng;ZHENG Minghui(Ningde People's Hospital,Ningde 352001,China)
出处
《临床合理用药杂志》
2021年第36期14-17,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
股骨粗隆间骨折
内固定术
低分子肝素
失血量
深静脉血栓形成
不良反应
Intertrochanteric fracture of femur
Internal fixation
Low molecular weight heparin
Latent blood loss
Deep venous thrombosis
Adverse reaction
