气压泵联合低分子肝素钙预防髋部骨折术后深静脉血栓的疗效分析

戴慧燕, 高荣荣, 徐佩, 卞玲, 桂冬梅

戴慧燕, 高荣荣, 徐佩, 卞玲, 桂冬梅. 气压泵联合低分子肝素钙预防髋部骨折术后深静脉血栓的疗效分析[J]. 实用临床医药杂志, 2019, 23(9): 24-26. DOI: 10.7619/jcmp.201909007
引用本文: 戴慧燕, 高荣荣, 徐佩, 卞玲, 桂冬梅. 气压泵联合低分子肝素钙预防髋部骨折术后深静脉血栓的疗效分析[J]. 实用临床医药杂志, 2019, 23(9): 24-26. DOI: 10.7619/jcmp.201909007
DAI Huiyan, GAO Rongrong, XU Pei, BIAN Ling, GUI Dongmei. Efficacy analysis of air pressure pump combinedwith low molecular weight heparin in preventing deep vein thrombosis after hip fracture operation[J]. Journal of Clinical Medicine in Practice, 2019, 23(9): 24-26. DOI: 10.7619/jcmp.201909007
Citation: DAI Huiyan, GAO Rongrong, XU Pei, BIAN Ling, GUI Dongmei. Efficacy analysis of air pressure pump combinedwith low molecular weight heparin in preventing deep vein thrombosis after hip fracture operation[J]. Journal of Clinical Medicine in Practice, 2019, 23(9): 24-26. DOI: 10.7619/jcmp.201909007

气压泵联合低分子肝素钙预防髋部骨折术后深静脉血栓的疗效分析

详细信息
    通讯作者:

    桂冬梅, E-mail: 090741@yzu.edu.cn

  • 中图分类号: R683

Efficacy analysis of air pressure pump combinedwith low molecular weight heparin in preventing deep vein thrombosis after hip fracture operation

  • 摘要:
      目的  探讨气压泵联合低分子肝素钙预防髋部骨折术后深静脉血栓的临床疗效。
      方法  将231例髋部骨折患者随机分为2组。A组(n=122)应用气压泵联合低分子肝素钙药物治疗, B组(n=109)单纯应用活血药治疗,比较2组术后D-二聚体、凝血指标异常患者比例,比较2组下床时间、住院时间、下肢深静脉血栓发生率、术后感染发生率。
      结果  A组术后发生D-二聚体异常10例(8.20%), B组18例(16.50%), 差异有统计学意义(P=0.01); A组发生凝血时间异常18例(14.80%), B组15例(13.80%), 差异无统计学意义(P=0.89)。A组有5例(4.10%)发生DVT, B组为13例(11.90%), A组住院时间短于B组,差异均有统计学意义(P < 0.05或P < 0.01)。
      结论  气压泵联合低分子肝素钙治疗能减少深静脉血栓的发生,促进患者恢复。
    Abstract:
      Objective  To explore the clinical efficacy of air pressure pump combined with low molecular weight heparin in preventing deep vein thrombosis (DVT) after operation for hip fracture.
      Methods  Totally 231 patients with hip fracture were randomly divided into two groups. Group A (n=122) was treated with air pressure pump combined with low molecular weight heparin, while group B (n=109) was treated with blood-activating drugs alone. The proportion of patients with abnormal D-dimer level and coagulation index after operation were compared between the two groups. The time of getting out of bed, hospitalization time, incidence rate of deep vein thrombosis of lower limbs and incidence rate of postoperative infection were compared between the two groups.
      Results  There were 10 cases (8.20%) with abdominal D-dimer level in group A and 18 cases (16.50%) in group B, and there was significant difference between two groups (P=0.01). There were 18 cases (14.80%) with abdominal coagulation time in group A and 15 cases (13.80%) in group B, and there was no significant difference between two groups (P=0.89). There were 5 cases (4.10%) of DVT in group A and 13 cases (11.90%) in group B, the hospitalization time in group A was shorter than that in group B, and there were significant differences between two groups (P < 0.05 or P < 0.01).
      Conclusion  Air pressure pump combined with low molecular weight heparin can reduce the incidence of DVT and promote recovery of patients.
  • 表  1   2组患者一般资料比较[n(%)]

    一般资料 A组(n=122) B组(n=109) T/Z/χ2 P
    性别 88(72.10) 75(68.80) 0.35 0.56
    34(27.90) 34(31.20)
    高血压 64(52.50) 55(50.50) 0.19 0.85
    糖尿病 22(18.00) 15(13.80) 1.40 0.16
    口服抗血小板药物 18(14.80) 10(9.20) 0.62 0.43
    口服抗凝药 2(1.60) 1(0.90) 0.48 0.63
    凝血功能障碍 17(13.90) 20(18.30) 0.91 0.36
    股骨粗隆间骨折分型(Evans-Jensen) 72(0.59) 70(0.64) 0.26 0.80
    39(0.32) 27(0.25)
    7(0.06) 10(0.09)
    4(0.03) 2(0.02)
    股骨颈骨折分型(Gardon分型) 82(67.20) 79(72.50) 0.63 0.53
    40(32.80) 30(27.50)
    手术方式 全髋关节 11(9.00) 10(9.20) 0.15 0.88
    半髋关节 25(20.50) 20(18.30)
    内固定 86(70.50) 79(72.50)
    下载: 导出CSV

    表  2   2组患者术后预后指标及并发症比较(x±s)[n(%)]

    组别 下床时间/d DVT 感染 住院时间/d
    A组(n=122) 13.46±1.99 5(4.10) 1(0.08) 18.31±6.15
    B组(n=109) 15.95±1.76 13(11.90)* 2(1.83) 22.60±5.03**
    DVT: 下肢深静脉血栓。与A组比较, *P < 0.05, **P < 0.01。
    下载: 导出CSV
  • [1]

    Ostrowka C, Bonhomme S, Jouffroy P, et al. Evaluation of venous thromboembolic complications in patients operated on for pelvic fracture[J]. Orthop Traumatol Surg Res, 2018, 104(6): 917-921. doi: 10.1016/j.otsr.2018.04.017

    [2]

    Cho Y H, Byun Y S, Jeong D G, et al. Preoperative incidence of deep vein thrombosis after hip fractures in korean[J]. Clin Orthop Surg, 2015, 7(3): 298-302. doi: 10.4055/cios.2015.7.3.298

    [3] 中华医学会骨科分会. 深静脉血栓形成的诊断和治疗指南[J]. 中华外科杂志, 2012, 50(7): 611-614. doi: 10.3760/cma.j.issn.0529-5815.2012.07.010
    [4] 胡志芬, 阳燕妮, 卢卫忠, 等. 老年髋部骨折患者围手术期深静脉血栓预防及护理对策[J]. 中国中医急症, 2017, 26(7): 1312-1314. doi: 10.3969/j.issn.1004-745X.2017.07.061
    [5] 张雨, 杨鹏. 护理干预对预防下肢骨折术后深静脉血栓形成的效果分析[J]. 世界临床医学, 2017, 11(4): 215-216. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201024062.htm
    [6] 付丽丽. 人工髋关节置换术的人性化护理的临床效果观察[J]. 中国民间疗法, 2017, 25(2): 82-83. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMJL201702073.htm
    [7] 缪中平, 吴云霞, 晏笑葵. 护理干预对预防老年患者人工髋关节置换术后下肢深静脉血栓的影响[J]. 浙江临床医学, 2015(7): 1256-1256. https://www.cnki.com.cn/Article/CJFDTOTAL-SLYY201707070.htm
    [8]

    Zhang Z D, Li Z, Li J, et al. Effects of natural hirudin and low molecular weight heparin in preventing deep venous thrombosis in aged patients with intertrochanteric fracture[J]. Sci Rep, 2018, 8(1): 8847-8852. doi: 10.1038/s41598-018-27243-1

    [9]

    Liew N C, Alemany G V, Angchaisuksiri P, et al. Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism[J]. Int Angiol, 2017, 36(1): 1-20. http://europepmc.org/abstract/MED/27606807

    [10] 蒋亚丽, 葛志娟, 蔡丽. 舒适护理对下肢多发骨折患者深静脉血栓的预防作用[J]. 国际护理学杂志, 2017, 36(20): 2785-2787. doi: 10.3760/cma.j.issn.1673-4351.2017.20.012
    [11] 赵君, 王璐, 郑云辉, 等. 优质护理应用于ICU护理中对气压泵血栓的预防作用[J]. 血栓与止血学, 2017, 23(6): 1074-1075. doi: 10.3969/j.issn.1009-6213.2017.06.066
    [12] 李秀华. 气压泵在脑出血术后昏迷患者预防下肢深静脉血栓的应用[J]. 实用临床护理学电子杂志, 2017, 2(37): 51-52. doi: 10.3969/j.issn.2096-2479.2017.37.042
    [13] 黄柳月. 护理干预在预防下肢骨折术后并发深静脉血栓的应用探析[J]. 中外医学研究, 2016, 14(26): 95-96. https://www.cnki.com.cn/Article/CJFDTOTAL-YJZY201626052.htm
    [14] 郑淑彬, 陆秀娟. 深静脉血栓形成的高危因素及预防护理进展[J]. 当代护士: 下旬刊, 2017(2): 15-18. doi: 10.3969/j.issn.1006-6411.2017.02.008
    [15] 王进, 郑欣, 宋子鉴, 等. 下肢骨折围术期抗凝治疗的研究进展[J]. 中华创伤杂志, 2017, 33(6): 570-574. doi: 10.3760/cma.j.issn.1001-8050.2017.06.019
表(2)
计量
  • 文章访问数:  302
  • HTML全文浏览量:  180
  • PDF下载量:  7
  • 被引次数: 0
出版历程
  • 收稿日期:  2019-02-15
  • 录用日期:  2019-03-24
  • 网络出版日期:  2020-12-21
  • 发布日期:  2019-05-14

目录

    /

    返回文章
    返回
    x 关闭 永久关闭