低分子量肝素预防老年人工全髋关节置换术后下肢深静脉血栓形成的疗效及对血浆D-二聚体含量的影响

发布时间：2018-05-02 03:16

本文选题：髋关节置换术 + 下肢静脉血栓　；参考：《中国老年学杂志》2017年01期

【摘要】：目的探讨低分子肝素治疗老年人工全髋关节置换术后预防下肢深静脉血栓形成的疗效及对血浆中D-二聚体含量变化的影响。方法进行人工全髋关节置换的老年患者98例,随机分为观察组和对照组,每组49例。观察组在围术期均给予低分子肝素预防治疗,对照组在围术期均未使用低分子肝素;两组患者术后比较彩色多普勒诊断深静脉血栓的结果并检测血浆中D-二聚体的含量。结果观察组患者的下肢深静脉血栓形成总发生率为10.20%,明显低于对照组的63.27%(P0.05);血浆D-二聚体阳性检出率和含量分别为22.45%、(1.75±0.93)mg/L,均明显低于对照组的57.14%、(2.21±0.88)mg/L(P0.05)。结论对髋关节置换手术老年患者给予低分子肝素治疗,可有效降低下肢深静脉血栓的形成;同时,通过对血浆D-二聚体含量的检测,能及时准确判断深静脉血栓的发生情况,对深静脉血栓的预防和治疗具有指导意义。
[Abstract]:Objective to investigate the effect of low molecular weight heparin (LMWH) on the prevention of deep venous thrombosis (DVT) in the lower extremity after total hip replacement (THR) in elderly patients and the effect of LMWH on plasma D-dimer content. Methods 98 elderly patients undergoing total hip replacement were randomly divided into observation group and control group with 49 cases in each group. The observation group was given low molecular weight heparin (LMWH) prophylaxis during perioperative period, the control group was not treated with LMWH during perioperative period, the results of color Doppler diagnosis of deep venous thrombosis (DVT) were compared between the two groups and the content of D-dimer in plasma was detected. Results the total incidence of deep venous thrombosis in lower extremities in the observation group was 10.20, which was significantly lower than that in the control group (63.27), and the positive rate and content of plasma D-dimer were 22.45 卤0.93 mg / L respectively, which were significantly lower than that in the control group (57.14 mg / L, 2.21 卤0.88 mg / L, P 0.05, respectively). Conclusion Low-molecular-weight heparin therapy for elderly patients undergoing hip arthroplasty can effectively reduce the formation of deep venous thrombosis in lower extremities, and can accurately judge the occurrence of deep venous thrombosis by detecting plasma D-dimer content. It is of guiding significance for the prevention and treatment of deep venous thrombosis.
【作者单位】：青海大学附属医院关节外科;
【分类号】：R687.4

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