低分子肝素联合压力泵预防老年髋部骨折深静脉血栓的临床观察

Observation on the clinical effects of low molecular weight heparin combined with pressure pump for prophylaxis of deep venous thrombosis in senile patients suffering from hip fracture

目的：观察采用低分子肝素（LMWH）联合压力泵预防老年髋部骨折后下肢深静脉血栓形成（DVT）的临床效果。方法：选择某守收治的143例高龄髋关节周围骨折患者,刚入院先行彩色多普勒血流超声显像仪检查,未发现下肢深静脉存在血栓的患者。随机分为单纯使用低分子肝素的对照组和用低分子肝素联合压力泵观察组。对照组57例,单纯使用低分子肝素预防;用低分子肝素联合压力泵观察组86例,所有患者术后7~10 d对2组进行双下肢血管彩超检查。结果：对照组中发生了14例DVT阳性,发生率24.56%;观察组中发生了10例DVT阳性,发生率11.63%;2组比较,差异有统计学意义（P〈0.05）。结论：用低分子肝素联合压力泵处理老年髋部骨折患者,可有效预防下肢深静脉血栓（DVT）形成,效果明显好于单纯使用低分子肝素者,手术后评价疗效也较好,值得临床上进一步推广。

OIMECTIVE To observe the clinicai effects of low molecular weight heparin （LMWH） combined with pressure pump for prophylaxis of deep venous thrombosis （DVT） in senile patients suffering from hip fracture. METHODS From Sep- tember 2011 to September 2012, 143 cases of elderly hip fracture patients were admitted to our hospital. All patients were checked by color Doppler ultrasound at the time of admission and no deep venous thrombosis of lower extremity existing. They were randomly divided into control group and observation group： 57 cases in control group were simply given with low molecu- lar weight heparin, while 86 cases in observation group were treated with low molecular weight heparin combined with pressure pump. All the patients in both groups were rechecked by color Doppler ultrasound for detecting deep venous thrombosis of low- er extremity 7- 10 days postoperatively. RESULTS 14 cases were positive of DVT in the control group with the incidence of 24. 56%, while 10 cases were positive in the observation group with the incidence of 11.63%. The difference between the two groups was statistically significant （P〈0. 05）. CONCLUSION The prophylaxis use of low molecular weight heparin combined with pressure pump in elderly patients with hip fracture can effectively prevent the deep venous thrombosis （DVT） formation. It is significantly better than those simply use of low weight molecular heparin. The evaluation of its curative effect is better af- ter operation,and is worthy of further clinical promotiorL