基于PFNA内固定的股骨粗隆间骨折患者低分子肝素治疗后的血红蛋白丢失量、PT、APTT、D-D的影响研究

Loss of Globin after Low-molecular-weight Heparin Treatment in Patients with Intertrochanteric Fractures Based on PFNA Internal Fixation,Effect of PT,APTT and D-D

目的 探究基于PFNA内固定的股骨粗隆间骨折患者低分子肝素治疗后的血红蛋白丢失量、PT、APTT、D-D的影响研究。方法 选取2019年1月—2021年1月在本院治疗的股骨粗隆间骨折的60例患者为研究对象,平均分成研究组和对照组。观察受试者失血情况、下肢深静脉血栓、凝血功能等指标发生情况。结果 研究组受试者的血红蛋白丢失量、隐性失血量、显性失血量、总失血量均低于对照组(t=4.588、5.180、2.586、3.752,P<0.05);研究组受试者下肢深静脉血栓发生率低于对照组,而未发生率高于对照组(χ^(2)=4.706,P=0.030);受试者经治疗后,研究组PT和APTT高于对照组,D-D低于对照组(t=9.742、8.685、2.840,P=0.000);术后,研究组受试者PV、HSV、LSV均低于对照组(t=3.273、7.658、5.392,P<0.05);研究组受试者不良反应总发生率高于对照组(χ^(2)=0.000,P=1.000)。结论 低分子肝素结合PFNA内固定治疗老年股骨粗隆间骨折取得的疗效较好,对患者机体的凝血功能改善效果明显,降低患者整个手术的出血量,使患者深静脉的血液黏滞性降低,降低患者发生下肢深静脉血栓的危险。

Objective To investigate the effects of low molecular weight heparin treatment on the amount of globin loss,PT,APTT and D-D in patients with intertrochanteric fracture of femur treated with PFNA internal fixation.Methods From January 2019 to January 2021,60 patients with intertrochanteric fracture of femur were selected in our hospital as research objects,and were evenly divided into study group and control group.Blood loss,lower extremity deep vein thrombosis,blood clotting function and other indicators were observed.Results The hemoglobin loss,recessive blood loss,dominant blood loss and total blood loss of the study group were lower than those of the control group(t=4.588,5.180,2.586,3.752,P<0.05);The incidence of lower extremity deep vein thrombosis in study group was lower than that in control group,but the incidence of absence was higher than that in control group(χ^(2)=4.706,P=0.030);After treatment,PT and APTT in research group were higher than those in control group,and D-D was lower than those in control group(t=9.742,8.685,2.840,P=0.000);After operation,PV,HSV and LSV of study group were lower than those of control group(t=3.273,7.658,5.392,P<0.05);The total incidence of adverse reactions in study group was higher than that in control group(χ^(2)=0.000,P=1.000).Conclusion Low molecular weight heparin combined with PFNA internal fixation in the treatment of elderly intertrochanteric fractures of femur has a good effect,significantly improving the blood function of patients,reducing the amount of blood loss during the operation,reducing the blood viscosity of deep veins,and reducing the risk of deep venous thrombosis of lower limbs.