高龄股骨颈骨折患者术后预防血栓形成的疗效研究

Prevention of thrombosis after surgery for elderly patients with femoral neck fracture

目的:探讨老年患者股骨颈骨折术后下肢深静脉血栓形成(DVT)的预防措施及其疗效。方法:高龄股骨颈骨折患者60例随机分为物理治疗组、肝素治疗组(低分子肝素钙+物理治疗)、联合药物治疗组(低分子肝素钙+低分子右旋糖酐+潘生丁+物理治疗)。观察术后下肢DVT、血小板计数、凝血功能及并发症。结果:物理活动治疗组、肝素治疗组及联合药物治疗组术后DVT的发生率分别为20%、5%、0(P<0.05)。联合药物治疗组术后血小板计数平均值明显低于其他两组(P<0.05)。所有病例均未发生大出血,凝血功能正常。结论:联合药物预防高龄股骨颈骨折患者术后DVT疗效确切,并发症少,安全性高。

Objective. To discuss preventive measure of deep venous thrombosis （DVT） of lower limb after surgery in elderly patients with femoral neck fracture. Methods. A total of 60 elderly patients with femoral neck fracture were divided into three groups： physiotherapy group, heparin therapy group （low molecular heparin calcium and physical treatment） and combined pharmacotherapy group （low molecular heparin calcium, low molecular dextran, persantin and physical treatment）. The incidence rate of DVT, blood platelet count （BPC）, coagulation function and complications were recorded after surgery. Results.. The incidence rates of DVT in physiotherapy, heparin therapy and combined pharmacotherapy groups were 20%, 5% and 0 respectively （P〈0.05）. The BPC in combined pharmacotherapy group was significantly lower than that in the other two groups （P 〈 0. 05）. Massive hemorrhage was not found and the coagulation function was normal in all patients. Conclusion： The combined pharmacotherapy is safe and effective for postoperative prevention of lower limb DVT in elderly patients with femoral neck fracture, without obvious complications.