低分子肝素钙联合气压式血液循环驱动器防治老年骨折患者术
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篇名: 低分子肝素钙联合气压式血液循环驱动器防治老年骨折患者术
TITLE:
摘要:

目的:观察低分子肝素钙联合气压式血液循环驱动器防治老年骨折患者术后下肢深静脉血栓形成的疗效及安全性。方

法:80 例接受手术治疗的下肢骨折老年患者按随机数字表法分为对照组和观察组,各40 例。对照组患者术后仅接受气压式血液

循环驱动器作下肢静脉血栓预防处理。观察组在对照组基础上加用低分子肝素钙注射液,于术前12 h 和术后12、24 h 皮下注射

0.4 ml,qd;术后2~3 d 皮下注射0.4 ml,qd;术后第4 天起皮下注射0.6 ml,qd。连续治疗10 d。观察两组患者下肢深静脉血栓的发

生情况、疗效、血液流变学指标及患侧、健侧肢周径差的变化,并比较两组患者不良反应发生率。结果:观察组患者总有效率

(95.00%)显著高于对照组(72.50%),组间比较差异有统计学意义(P<0.05);治疗后,观察组患者患侧、健侧肢周径差减少(1.10±

0.87)cm,显著低于对照组(2.59±1.55)cm,组间比较差异有统计学意义(P<0.05);观察组患者全血高切黏度、全血低切黏度、血浆

黏度及纤维蛋白原水平均优于对照组,差异有统计学意义(P<0.05);两组患者均未见明显不良反应发生。结论:低分子肝素钙联合

气压式血液循环驱动器防治老年骨折患者术后下肢深静脉血栓形成的有效率高,患者血液流变学指标改善明显,且安全性较好。

ABSTRACT:

OBJECTIVE:To observe therapeutic efficacy and safety of low molecular heparin calcium(fraxiparine)combined

with vapour-pressure type blood circulation driver for the prevention and treatment of postoperative lower limb deep vein thrombosis(

DVT)in elderly fracture patients. METHODS:80 elderly patients receiving fracture surgery were randomly divided into control

group and observation group,with 40 cases in each group. Control group only received preventive measures for lower limb

DVT under the action of vapour-pressure type blood circulation driver,while observation group was additionally given Low molecular

heparin calcium injection on the basis of control group,Preoperative 2 h,postoperative 12 h and 24 h,0.4 ml was administrated;

Postoperative d2-d3,0.4 ml was subcutaneously injected;postoperative d4,0.6 ml was administrated and lasted for 10 d. The

incidence of lower limb venous thrombosis,therapeutic efficacy,the changes of blood rheology indexes and the cross-section diameter

difference of uninjured side limb were observed in 2 groups;the incidence of ADR was compared between 2 groups. RESULTS:

The observation group;total effective rate(95.00%)was higher than control group(72.50%),with statistical significance(

P<0.05). After treatment,the cross-section diameter difference of side and uninjured side limb in observation group decreased

to(1.10±0.87)cm,which was significantly lower than control group(2.59±1.55)cm,with statistical significance(P<

0.05). The blood viscosity at both high and low shear rates,plasma viscosity and fibrinogen of observation group were all better

than those of control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:In

the prevention of lower limb DVT in elderly fracture patients,Low molecular heparin calcium injection combined with vapour-pressure

type blood circulation driver show high effective rate,significantly improve blood rheological index and lower the incidence of

lower limb DVT with good safety.

期刊: 2015年第26卷第35期
作者: 梁兵鑫,胡三保
AUTHORS: LIANG Bing-xin,HU San-bao
关键字: 骨折;下肢;深静脉血栓;低分子肝素钙;气压式血液循环驱动器
KEYWORDS: Fracture;Lower limb;Deep venous thrombosis;Low molecular heparin calcium injection;Vapour-pressure type
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