股骨干骨折患者围手术期发生下肢深静脉血栓的特点

发布时间：2018-03-03 19:41

本文选题：骨植入物　切入点：股骨干骨折　出处：《中国现代医学杂志》2017年18期 　论文类型：期刊论文

【摘要】：目的了解采用股骨髓内钉固定治疗股骨干骨折的患者围手术期下肢深静脉血栓发生的时间分布特点。方法选取2010年10月-2016年10月208例在承德医学院附属医院创伤骨科采用手术治疗的股骨干骨折患者,根据患者术前是否采用预防性抗凝措施分为抗凝组和非抗凝组,两组患者分别于伤后第1、3、5及超过5天和术后第2、5、7及14天8个时间点分别进行下肢血管彩色多普勒检查,统计总的血栓发生例数和发生率,并对两组患者进行比较。统计不同时间点两组患者新发生血栓的病例数和发生率,通过频数分布表分析伤后和术后血栓发生的高峰时间。结果根据纳入标准共纳入208例患者,其中术前抗凝组115例,有16例发生血栓,发生率13.91%,术前未抗凝组93例,发生深静脉血栓27例,发生率29.03%。两组比较差异有统计学意义(χ~2=7.167,P=0.007)。两组患者血栓发生的高峰时间是伤后第3天和术后第1天。结论股骨干骨折患者围手术期,深静脉血栓发生的高峰时间是伤后前第3天和术后第1天。患肢深静脉血栓的预防应从伤后即开始实施,伤后就进行药物预防性抗凝可降低深静脉血栓的发生率。
[Abstract]:Objective to investigate the temporal distribution of deep venous thrombosis of lower extremity in patients with femoral shaft fracture treated by femoral bone marrow nail fixation. Methods from October 2010 to October 2016, 208 cases of trauma in the affiliated hospital of Chengde Medical College were selected. Fracture of femoral shaft treated by surgery in orthopedic department, The patients were divided into anticoagulant group and non-anticoagulant group according to whether preventive anticoagulant measures were used before operation. The lower extremity blood vessels were examined by color Doppler imaging at 8 time points, 1 and 5 days after injury and more than 5 days after injury, and 7 and 14 days after operation, respectively. Count the total number and incidence of thrombosis, and compare the two groups of patients. Statistics of the two groups of patients at different time points of the number and incidence of new cases of thrombus, Results according to the inclusion criteria, 208 patients were included in this study. There were 115 cases in the preoperative anticoagulant group, 16 cases in the anticoagulant group, the incidence rate was 13.91%, and 93 cases in the non-anticoagulant group before operation. There were 27 cases of deep venous thrombosis, the incidence rate was 29.03.The difference between the two groups was statistically significant (蠂 2 / 7.167). The peak time of thrombosis in the two groups was 3 days after injury and 1 day after operation. Conclusion the perioperative period of femoral shaft fracture patients, The peak time of deep venous thrombosis was 3 days before injury and 1 day after operation. The prevention of deep vein thrombosis in the affected limb should be carried out from after injury, and the incidence of deep vein thrombosis could be reduced by drug preventive anticoagulation after injury.
【作者单位】：承德医学院附属医院创伤骨科;承德医学院附属医院新生儿科;
【基金】：承德市科技局资助课题(No:201601A045)
【分类号】：R687.3

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