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

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

扬州大学附属医院骨科, 江苏扬州, 225009

详细信息

通讯作者:
桂冬梅, E-mail: 090741@yzu.edu.cn

中图分类号: R683
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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

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

Department of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225009

摘要

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。
- 气压泵 /
- 低分子肝素钙 /
- 深静脉血栓 /
- 髋部骨折 /
- 手术
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.
- air pressure pump /
- low molecular weight heparin /
- deep vein thrombosis /
- hip fracture /
- surgery

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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值	P值
性别	男	88(72.10)	75(68.80)	0.35	0.56
	女	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)	Ⅱ	72(0.59)	70(0.64)	0.26	0.80
	Ⅲ	39(0.32)	27(0.25)
	Ⅳ	7(0.06)	10(0.09)
	Ⅴ	4(0.03)	2(0.02)
股骨颈骨折分型(Gardon分型)	Ⅲ	82(67.20)	79(72.50)	0.63	0.53
	Ⅳ	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)

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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。

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