低分子肝素对脊柱外科患者术后住院期间下肢深静脉血栓的预防作用

Preventive effect of low molecular weight heparin on deep vein thrombosis of the lower extremity during postoperative hospitalization in spinal surgery patient

目的探讨低分子肝素对脊柱外科患者术后住院期间下肢深静脉血栓的预防作用。方法收集2020年1月至2022年5月于首都医科大学附属北京世纪坛医院住院接受手术治疗的98例患者的临床资料,根据术后预防方案的不同将患者分为治疗组(n=51,术后给予低分子肝素治疗)和对照组(n=47,术后给予常规干预)。比较两组患者的脊柱专科信息、手术相关指标以及术后住院期间下肢深静脉血栓的发生情况、凝血功能。结果两组患者的疾病类型以骨折和椎间盘突出为主,手术部位以腰骶椎为主。两组患者的脊柱专科信息和手术相关指标比较,差异均无统计学意义(P﹥0.05)。术后住院期间,治疗组患者D-二聚体水平升高的比例低于对照组患者,差异有统计学意义(P﹤0.05)。两组患者均未发生肺栓塞和出血事件,但治疗组患者下肢深静脉血栓的发生率低于对照组患者,差异有统计学意义(P﹤0.05)。两组患者的凝血酶原时间、国际标准化比值比较,差异均无统计学意义(P﹥0.05)。结论低分子肝素可以有效降低脊柱手术患者术后下肢深静脉血栓的发生风险,可在临床推广使用。

Objective To investigate the preventive effect of low molecular weight heparin on deep vein thrombosis of the lower extremity in patient undergoing spinal surgery during postoperative hospitalization.Method The clinical data of 98 patients who were hospitalized and underwent surgical treatment at Beijing Shijitan Hospital,Capital Medical University from January 2020 to May 2022 were collected,the patients were divided into treatment group(n=51,given postoperative low molecular weight heparin treatment)and control group(n=47,given postoperative routine intervention)according to diverse postoperative prevention plans.The spinal specialist information and surgery-related indicators,as well as the occurrence of deep vein thrombosis of the lower extremity and coagulation function during postoperative hospitalization were compared between the two groups of patients.Result The disease types of the two groups of patients were mainly fractures and disc herniations,and the main surgical sites were lumbosacral vertebrae.There was no statistically significant difference in spinal specialist information and surgery-related indicators between the two groups of patients(P>0.05).During the postoperative hospitalization,the proportion of patients in the treatment group with elevated postoperative D-dimer levels was lower than that of the patients in the control group,and the difference was statistically significant(P<0.05).No pulmonary embolism bleeding events occurred in the two groups of patients,while the incidence rate of deep vein thrombosis in the lower extremity of the treatment group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in prothrombin time and international normalized ratio between the two groups of patients(P>0.05).Conclusion The risk of lower extremity deep vein thrombosis after spinal surgery could be effectively controlled by the employment of low molecular weight heparin which could be widespread promotion in clinical practice.