老年髋部骨折手术患者静脉血栓栓塞症药物预防的研究进展

Research progress on drug prevention of venous thromboembolism in elderly patients undergoing hip fracture surgery

安全有效使用抗凝药物是老年髋部骨折手术患者静脉血栓栓塞症预防的基础,术后一般预防、物理预防与药物预防应协同进行。本文综述老年髋部骨折手术后静脉血栓栓塞症药物预防发展过程,比较非肠道用药抗凝剂、新型口服抗凝剂类、香豆素抗凝血剂、抗血小板凝集药物,以及内服中药方剂抗凝机制和护理要点,介绍出凝血时间监测、血小板计数检查、D-二聚体、血栓弹力图、出血事件发生率、胃肠道反应在静脉血栓栓塞症药物预防效果监测中的作用。

The safe and effective use of anticoagulants is the basis for the prevention of venous thromboembolism in elderly patients after hip fractures surgery.Postoperative general prevention,physical prevention and drug prevention should be coordinated.This article reviewed the development process of drug prevention for venous thromboembolism after hip fracture surgery in the elderly,compared the anticoagulant mechanisms and nursing points of parenteral anticoagulants,new oral anticoagulants,coumarin anticoagulants,antiplatelet aggregation drugs and oral traditional Chinese medicine prescriptions,and introduced the role of clotting time monitoring,platelet count,D-dimer,thromboelastogram,incidence of bleeding events,and gastrointestinal reactions in the monitoring of the preventive effect of venous thromboembolism drugs.