老年髋部骨折患者围手术期凝血功能变化的临床意义

The Changes and Clinical Significant of Perioperative Blood Coagulation in Elderly Patients with Hip Fractures

目的通过观察老年髋部骨折手术患者围手术期凝血全项及血小板计数,探讨围手术期凝血及血小板的变化规律及其可能影响因素。方法将38例老年髋部骨折手术患者分别于手术前、术后1、3、5、7 d,采血检测凝血全项、血小板计数。结果 38例老年髋部骨折患者术后血液凝固性不同程度增高。所有患者术后第1、3、5天的凝血酶原时间、凝血酶时间及活化部分凝血活酶时间均延长,差异有统计学意义(P<0.05);纤维蛋白原则在术后第3天升到最高点,差异有统计学意义(P<0.01)。与术前比较血小板计数均出现显著下降,术后第1天最低,差异有统计学意义(P<0.01)。结论老年髋部骨折手术患者由于解剖形态特殊,围手术期存在创伤、手术、大量失血等刺激,导致凝血机能亢进,患者术后处于高凝状态。

Objective To observe the perioperative coagulation and platelet in elderly patients with hip fractures,and explore the perioperative changes of coagulation and platelet in the law and its possible influencing factors.Methods 38 cases with hip fractures were tested on preoperative and postoperative 1,3,5,7 day all items of blood coagulation,platelet count.Results The postoperative blood coagulation of 38 cases with hip fracture increased to varying degrees.All patients postoperative 1,3,5 day of the prothrombin time,thrombin time and activated partial thromboplastin time were extended,the difference had statistically significantP〈0.05;fibrinogen principle in postoperative 3 day rise to the highest points,the difference was statistically significant P〈0.01.Platelet count decreased significantly compared with the preoperative.Postoperative 1 day of the platelet count was the lowest,the difference was statistically significant P〈0.01.Conclusion Due to the special anatomy,trauma,surgery,blood loss and so stimulated elderly patients with hip fracture during perioperative period.Led blood coagulation into hyper-coagulation,patients were in the postoperative hypercoagulable state.