低分子肝素对髋、膝关节术后下肢深静脉血栓形成的预防作用

Preventive effect of low molecular weight heparin on deep venous thrombosis due to surgery of hip and knee joint replacement

目的:研究应用低分子肝素预防髋、膝关节手术后下肢深静脉血栓(DVT)发生的有效性和安全性。方法:入选96例髋、膝关节手术患者,随机分为两组,观察组和对照组分别为49例和47例,观察组中全髋关节置换术18例,全膝关节置换术12例,动力髋螺钉(DHS)19例;对照组中全髋关节置换术19例,全膝关节置换术11例,DHS17例。比较两组术后血红蛋白、血小板变化及双下肢DVT和不良反应发生情况。结果:观察组、对照组患者术后下肢DVT发生率分别为6.12%(3/49)、25.5%(12/47),差异有统计学意义(P<0.05);两组患者手术前、后血红蛋白、血小板差异无统计学意义(P>0.05)。观察组总的不良反应发生率为4.08%(2/49)。结论:预防性使用低分子肝素可以降低髋、膝关节置换术后DVT的发生,不良反应发生率低。

Objective：To observe preventive effect and safty of low molecular weight heparin on deep venous thrombosis（DVT）due to hip or knee joint replacement.Methods：From February 2007 to July 2009,according to the selection criteria,96 patients were selected into this study,and randomly dibided into two groups：49 in the observation group and 47 in the control group.The observation group included 18 cases with total hip arthroplasty（THA）,12 cases with total knee arthroplasty（TKA）,and 19 cases with dynamic hip screw（DHS）.The control group included 19 THA cases,11 TKA cases,and 17 DHS cases.The incidence of side-effect,and level of hemoglobin（Hb）and platelet（Pt）were observed and compared.Results：In the observation group,3 patients had DVT with a rate of 6.12%（3/49）.In the control group,DVT occurred in 12 cases with an incidence of 25.5%（12/47）.A significant difference in DVT incidence was found between these two groups（P〈0.05）.There was no significant change of Hb,Pt between postoperative and perioperative（P〉0.05）.The total incidence of side effects in the investigation group was 4.08%（2/49）.Conclusion：Low molecular weight heparin can reduce the incidence of DVT after hip or knee replacements with a low incidence of side effect.