低分子肝素对中老年骨折患者下肢深静脉血栓形成的预防作用

Preventive effects of low molecular weight heparin on the formation of lower limbs deep venous thrombosis in quinquagenarian bone fracture patients

目的探讨低分子肝素对中老年骨折患者下肢深静脉血栓形成的预防作用。方法对2000～2005年未应用低分子肝素的骨折患者(单纯运动组)及2005年后应用低分子肝素预防DVT的患者(LMWH组)的临床资料进行分析统计。结果单纯运动组DVT发生率为15.8%(38/240),LMWH组为1.4%(4/279),两组相比差异有统计学意义(χ2=6.34,P<0.05)。手术后,单纯运动组APTT、Fig均较前显著增加(P<0.05),LMWH组APTT、Fig稳定(P>0.05),手术前后上述指标前后差值组间比较,差异有统计学意义(P<0.05)。两组患者术中出血量、术中输血量、术后引流量差异均无统计学意义(P>0.05)。结论低分子肝素干预预防中老年患者骨折术后DVT形成效果确切,可显著降低骨折术后DVT形成发生率,安全性好,值得进一步探讨推广。

Objective To explore the preventive effect of low molecular weight heparin on the formation of lower limbs deep venous thrombosis in quinquagenarian bone fracture patients.Methods The clinical data of bone fracture patients without application of low molecular weight heparin（pure exercise group） from 2000 to 2005 and patients with low molecular weight heparin to prevent DVT（LMWH group） after 2005 were analyzed and compared.Results The DVT occurrence rate of the pure exercise group was 14.8%（38/240） while that of the LMWH group was 1.5%（4/279）.The comparison between the two groups had statistical differences（P0.05）.After operations,the APTT and Fig of the pure exercise group significantly increase（P0.05）,while the APTT and Fig of the LMWH group were stable.The differences between the preoperative and postoperative indexes of the two groups had statistical significance（P0.05）.The intraoperative bleeding,intraoperative blood transfusion and postoperative drainage in the two groups had no statistical difference.Conclusion Low molecular weight heparin can prevent the formation of DVT in quinquagenarian patients after bone fracture operation.