下肢骨折手术患者序贯用药预防静脉血栓的效果

Effect of Sequential Medication in the Prevention of Venous Thrombosis in Patients with Lower Extremity Fractures Surgery

目的:探究下肢骨折手术患者序贯用药预防静脉血栓的效果。方法:选取荣县人民医院2020年1月-2021年6月收治的500例下肢骨折手术患者。随机将其分为观察组和对照组,各250例。对照组给予常规用药(磺达肝癸钠),观察组给予序贯用药(在对照组基础上术后第10~18天口服阿司匹林肠溶片)。比较两组术前,术后1、2、3个月下肢静脉血栓发生率、凝血功能,术后2 d~1个月出血不良事件。结果:术后3个月内,观察组下肢静脉血栓发生率为3.20%,显著低于对照组的19.60%(P<0.05)。术后1个月,观察组血小板计数高于对照组,PT、APTT均长于对照组,血浆D-D水平低于对照组(P<0.05),术后2、3个月,两组血小板计数、PT、APTT、血浆D-D水平相应指标均逐渐恢复正常,且差异无统计学意义(P>0.05)。术后2 d~1个月,观察组出血不良事件发生率(3.20%)明显低于对照组(9.60%)(P<0.05)。结论:对下肢骨折手术患者采取序贯用药,可有效预防静脉血栓,积极改善凝血功能,减少出血不良事件,效果确切,值得参考。

Objective:To explore the effect of sequential medication in the prevention of venous thrombosis in patients with lower extremity fractures surgery.Method:A total of 500 patients with lower extremity fracture surgery admitted to Rong County People’s Hospital from January 2020 to June 2021 were selected.They were randomly divided into observation group and control group,with 250 cases in each group.The control group was given the routine medication(Fondaparinux Sodium),and the observation group was given sequential medication(Aspirin Enteric-coated Tablets were taken orally from 10 to 18 days after operation based on the control group).The incidence of lower limbs venous thrombosis and coagulation function before surgery,1,2 and 3 months after surgery,and bleeding adverse events 2 d to 1 month after surgery were compared between the two groups.Result:Within 3 months after surgery,the incidence of lower extremity venous thrombosis in the observation group was 3.20%,which was significantly lower than 19.60%in the control group(P<0.05).One month after surgery,the platelet count in the observation group was higher than that in the control group,PT and APTT in the control group were longer than those in the control group,and the plasma D-D level was lower than that in the control group(P<0.05).Two and three months after surgery,the platelet count,PT,APTT and plasma D-D levels in the two groups gradually returned to normal,and the differences were not statistically significant(P>0.05).2 d to 1 month after surgery,the incidence of bleeding adverse events in the observation group(3.20%)was significantly lower than 9.60%in the control group(P<0.05).Conclusion:Sequential medication for patients with lower extremity fractures surgery can effectively prevent venous thrombosis,actively improve coagulation function,reduce bleeding adverse events,the effect is accurate,worthy of reference.