低分子肝素应用于膝关节镜术后的临床观察

Clinical effects observation on the application of low molecular weight heparin after knee arthroscopic surgery

目的探讨膝关节镜术后低分子肝素的应用价值。方法分析2012年1月-2013年1月337例膝关节镜手术,术后分为治疗组180例和对照组157例,治疗组予常规预防应用低分子肝素钙,对照组不应用低分子肝素及其它抗凝血药物和辅助溶血栓药物。观察术后关节积血、下肢深静脉血栓栓塞和肺栓塞的发生率。结果关节积血:治疗组16例(8.8%);对照组2例(1.3%)。术后30d内经超声确诊发生患肢深静脉血栓栓塞:治疗组1例;对照组5例。2组均未发现具有临床症状的深静脉血栓栓塞,治疗组也未发现具有明显临床症状肺栓塞,但对照组发生1例。结论应用抗凝血药物是膝关节镜术后关节积血的原因之一。对于无血栓形成风险因素的患者,其应用是没有必要的,早期的功能康复锻炼可以达到有效预防深静脉血栓栓塞和肺栓塞的作用。

Objective To discuss the clinical effects of low molecular weight heparin after arthroscopic surgery of the knee. Methods A analysis of 337 cases of arthroscopic surgery of the knee were done from January 2012 to January 2013. To- tally 337 patients were randomly divided into treatment group （n = 180 cases） and control group （n = 157 cases）. The treat- ment group was given routine preventive application of low molecular heparin calcium ;while the control group was not applied low molecule heparin and other anticoagulant and assisted thrombolytic drug. The occurrence of hemarthrosis, deep venous thrombosis （DVT） and pulmonary embolism were observed after surgery. Results Hemorrhage were founded 16 cases （8.8%） in treatment group and 2 cases （1.3%） in control group. DVT were founded 1 case in treatment group and 5 cases in control group by sonogram. Symptomatic DVT was not be founded in 2 groups. Symptomatic puhnonary embolism was founded I case in control group. Conclusion The antithrombotic drugs could cause the hemarthrosis after arthroscopic surgery of the knee, the application of which is not necessary for patients without risk factors. The functional rehabilitation exercises can pre- vent DVT and pulmonary embolism.