老年人脊柱手术后深静脉血栓的诊断与预防

发布时间：2018-04-10 03:18

本文选题：脊柱　切入点：静脉血栓形成　出处：《中国组织工程研究》2017年23期

【摘要】：背景:深静脉血栓是骨科术后常见并发症,预防和治疗下肢深静脉血栓至关重要,但是老年人脊柱手术后深静脉血栓发生率和预防研究的较少。目的:探讨老年人脊柱手术后深静脉血栓的诊断及低分子肝素钙预防脊柱手术后深静脉血栓发生的疗效。方法:将行脊柱手术的患者根据术后是否应用低分子肝素钙分为2组,未应用者为对照组,应用低分子肝素钙组在脊柱术后12 h皮下注射低分子肝素钙0.4 mL(4 100 IU),次日起每天1次皮下注射至7-14 d。治疗前及治疗结束后分别检测凝血活酶时间、凝血酶时间、活化部分凝血活酶时间、血浆纤维蛋白原;记录术后切口引流量及术前术后下肢血管彩超检查结果。结果与结论:(1)低分子肝素钙组治疗后血浆纤维蛋白原降低,凝血酶时间、凝血活酶时间、活化部分凝血活酶时间轻度延长,但均在正常范围内;(2)低分子肝素钙组深静脉血栓的发生为0,显著低于对照发生率5%(P0.05);(3)结果说明,脊柱手术后应用低分子肝素钙明显的降低了深静脉血栓发生。
[Abstract]:Background: deep venous thrombosis (DVT) is a common complication after orthopedic surgery. Prevention and treatment of DVT in lower extremity is very important.Objective: to investigate the diagnosis of deep venous thrombosis after spinal surgery in the elderly and the effect of low molecular weight heparin calcium (LMWH) on the prevention of deep venous thrombosis (DVT) after spinal surgery.Methods: patients undergoing spinal surgery were divided into two groups according to whether or not they received low molecular weight heparin calcium.Low molecular weight heparin calcium (LMWHC) was subcutaneously injected with LMWH 0.4 mL(4 100IUU at 12 hours after spinal operation, and was subcutaneously injected daily for 7-14 days from the next day.The thromboplastin time, thrombin time, activated partial thromboplastin time and plasma fibrinogen were measured before and after treatment.Results and conclusion the plasma fibrinogen was decreased, thrombin time, thromboplastin time and activated partial thromboplastin time were slightly prolonged in low molecular weight heparin calcium group.But the incidence of DVT in LMWHC group was 0, which was significantly lower than that in control group (P 0.05). The results showed that LMWH significantly decreased the incidence of DVT after spinal surgery.
【作者单位】：云南省大理市第一人民医院骨科;内蒙古通辽市奈曼旗人民医院消化内镜室;
【分类号】：R687.3

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