下肢骨折内固定术后深静脉血栓形成的预防

Prevention of Deep Venous Thrombosis after Internal Fixation of Lower Limb Fractures

目的总结下肢骨折内固定术后,运用低分子肝素钠结合气压治疗预防深静脉血栓形成的经验。方法 2006年7月～2010年6月收治的下肢长骨骨折患者776例(其中股骨骨折427例、胫骨骨折349例),术后皮下注射低分子肝素钠结合间歇充气加压,预防深静脉血栓形成;术后行下肢深静脉彩色多普勒血流显像检查及后期随访,观察有无出血并发症发生。结果术后无伤口大出血病例,无出血性并发症发生。术后近期检查诊断下肢深静脉血栓形成5例,无肺栓塞发生。术后2～3月无深静脉血栓新发病例。结论低分子肝素钠结合气压治疗,预防下肢骨折内固定术后深静脉血栓形成效果满意。

Objective To summarize the experience of using low molecular weight heparin sodium combined with air pressure treatment to prevent the form of deep venous thrombosis after the internal fixation of lower limb fractures.Methods From July 2006 to June 2010,postoperative subcutaneous injections of low molecular weight heparin sodium combined with intermittent pneumatic compression were put on 776 cases with bone fractures of the lower limbs（including 427 cases with femoral fractures and 349 cases with tibial fractures）,to prevent the form of deep vein thrombosis.Meanwhile,color doppler flow imaging examination of postoperative deep veins of lower limb were carried out with follow-up visits on these cases to observe if there was any bleeding complication.Results There were no postoperative wound massive hemorrhage and hemorrhagic complications occurred.Only 5 cases were found lower limbs diagnosis of deep venous thrombosis in recent checking.There were no pulmonary embolism occurred and no new cases of deep vein thrombosis happened in the following 2 ～ 3 months after the operation.Conclusion The treatment of low molecular weight heparin sodium combined with air pressure can prevent the form of deep venous thrombosis after the internal fixation of lower limb fractures with satisfactory effects.