股骨转子间骨折抗凝与否的出血比较分析
发布时间：2019-01-24 21:19
【摘要】：目的 分析低分子肝素对股骨转子间骨折围术期失血量的影响,为临床应用低分子肝素预防股骨转子间骨折围术期抗凝提供参考。 方法 回顾性分析我科2008年1月至2014年12月股骨转子间骨折采用闭合复位髓内钉的患者,按低分子肝素抗凝时间方案的不同,男女分别计算比较围术期失血量和隐性失血量,分析低分子肝素对失血量的影响。 结果 男性病人组：(1)术后第1天,术前术后均不抗凝组总失血量、隐性失血量显著大于术前术后均抗凝组,差异有统计学意义(P0.05)；术后抗凝组与另外两组比较总失血量无统计学差异(P0.05)。(2)术后第3天,术前术后均不抗凝组、术后抗凝组、术前术后均抗凝组三组患者总失血量、隐性失血量,三组之间均无统计学差异(P0.05)。 女性病人组：(1)术后第1天,术前术后均不抗凝组、术后抗凝组、术前术后均抗凝组三组患者总失血量、隐性失血量,三组之间无统计学差异(P0.05)。(2)术后第3天,术前术后均不抗凝组、术后抗凝组、术前术后均抗凝组三组患者总失血量、隐性失血量,三组之间无统计学差异(P0.05)。 结论 低分子肝素可有效抑制血栓的形成,且引起的出血风险很小,临床上对股骨转子间骨折病人应术前术后常规抗凝。
[Abstract]:Objective to analyze the effect of low molecular weight heparin (LMWH) on perioperative blood loss of intertrochanteric fracture of femur, and to provide reference for clinical application of LMWH to prevent anticoagulation during perioperative period of intertrochanteric fracture of femur. Methods the patients with intertrochanteric fracture of femur treated with closed reduction intramedullary nail from January 2008 to December 2014 were analyzed retrospectively according to low molecular weight heparin anticoagulant time (LMWH). The effect of low molecular weight heparin (LMWH) on blood loss was analyzed. Results in male patients group: (1) on the 1st day after operation, the total blood loss and recessive blood loss were significantly higher in the non-anticoagulant group than in the pre-operative and post-operative anticoagulant group (P0.05); There was no significant difference in total blood loss between the anticoagulant group and the other two groups (P0.05). (2) on the 3rd day after operation, no anticoagulant group before and after operation, anticoagulant group after operation, total blood loss and recessive blood loss in the three groups before and after operation. There was no statistical difference among the three groups (P0.05). Female patients group: (1) on the first day after operation, no anticoagulant group, postoperative anticoagulant group, preoperative and postoperative anticoagulant group, three groups of patients with total blood loss, recessive blood loss, There was no significant difference among the three groups (P0.05). (2) on the 3rd day after operation, no anticoagulant group, postoperative anticoagulant group, preoperative and postoperative anticoagulant group, total blood loss, recessive blood loss, There was no statistical difference among the three groups (P0.05). Conclusion Low-molecular-weight heparin can effectively inhibit the formation of thrombus, and the risk of bleeding is very small. The routine anticoagulant therapy should be performed before and after operation in patients with intertrochanteric fracture of femur.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
[Abstract]:Objective to analyze the effect of low molecular weight heparin (LMWH) on perioperative blood loss of intertrochanteric fracture of femur, and to provide reference for clinical application of LMWH to prevent anticoagulation during perioperative period of intertrochanteric fracture of femur. Methods the patients with intertrochanteric fracture of femur treated with closed reduction intramedullary nail from January 2008 to December 2014 were analyzed retrospectively according to low molecular weight heparin anticoagulant time (LMWH). The effect of low molecular weight heparin (LMWH) on blood loss was analyzed. Results in male patients group: (1) on the 1st day after operation, the total blood loss and recessive blood loss were significantly higher in the non-anticoagulant group than in the pre-operative and post-operative anticoagulant group (P0.05); There was no significant difference in total blood loss between the anticoagulant group and the other two groups (P0.05). (2) on the 3rd day after operation, no anticoagulant group before and after operation, anticoagulant group after operation, total blood loss and recessive blood loss in the three groups before and after operation. There was no statistical difference among the three groups (P0.05). Female patients group: (1) on the first day after operation, no anticoagulant group, postoperative anticoagulant group, preoperative and postoperative anticoagulant group, three groups of patients with total blood loss, recessive blood loss, There was no significant difference among the three groups (P0.05). (2) on the 3rd day after operation, no anticoagulant group, postoperative anticoagulant group, preoperative and postoperative anticoagulant group, total blood loss, recessive blood loss, There was no statistical difference among the three groups (P0.05). Conclusion Low-molecular-weight heparin can effectively inhibit the formation of thrombus, and the risk of bleeding is very small. The routine anticoagulant therapy should be performed before and after operation in patients with intertrochanteric fracture of femur.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
【共引文献】
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