下肢骨折围术期抗凝治疗对下肢深静脉血栓形成影响.docVIP

下肢骨折围术期抗凝治疗对下肢深静脉血栓形成影响 　　[摘要] 目的：探讨下肢骨折围术期抗凝治疗对下肢深静脉血栓形成的影响。方法：分析2008～2011年152例接受下肢骨折手术、围术期应用低分子肝素钙或口服利伐沙班片的患者（A组）的临床资料，统计血栓发生率，同2008年152例前下肢骨折围术期未予抗凝药物干预的患者（B组）血栓发生情况进行对比。结果：A组8例（5.26%）发生深静脉血栓，B组38例（25.00%）发生深静脉血栓，两组比较，差异有统计学意义（P＜0.05）；且两组均未发生明显大出血。结论：围术期积极抗凝治疗，可大大降低下肢深静脉血栓形成的发生率。 　　[关键词] 下肢骨折；深静脉血栓；低分子肝素钙；利伐沙班；围术期 　　[中图分类号] R687.4 [文献标识码]B [文章编号]1673-7210（2011）07（b）-231-02 　　 　　Lower limb fractures perioperative anticoagulant therapy in the lower extremities,the influence of deep venous thrombosis 　　LI Jun, HOU Kai, TIAN Weihua, CAO Junshe, XU Xinghui, YUE Wei, ZHANG Qin 　　Departments of Bone and Joint,Baoji City Hospital of Chinese Medicine in Shanxi Province,Baoji 721000,China 　　[Abstract] Objective: To observe lower limb fractures perioperative anticoagulant therapy of lower limb vein thrombosis influence. Methods: Since 2008 to 2011,152 patients accepted lower limb fractures surgery,perioperative used low molecular heparin calcium or Rivaroxaban tablets slice of patients (group A),statistical thrombosis incidence of 2008,152 Patients with lower limb fractures perioperative instabilities anticoagulant utilized intervention of patients(group B)thrombosis occured by comparing. Results: A group of eight cases(5.26%) had deep vein thrombosis,group B 38 cases(25.00%) had deep vein thrombosis,two groups,the difference was statistically significant (P＜0.05). And two groups were not pronounced hemorrhage. Conclusion: The perioperative active anticoagulant therapy can greatly reduce varicose veins thrombosis incidence. 　　[Key words] Lower limb fractures;Deep vein thrombosis;Low molecular heparin calcium;Rivaroxaban tablets;Perioperative 　　 　　 　　下肢深静脉血栓（DVT）是骨科常见并发症，一般下肢骨折后治疗常需要牵引、制动，加之创伤后血管内壁损伤，此时因静脉血流缓慢，在瓣窦内形成涡流，使瓣膜局部缺氧，引起白细胞粘??分子表达，白细胞粘附及迁移，容易形成下肢深静脉血栓[1]，一旦血栓脱落造成慢性静脉功能不全或进一步形成肺栓塞，可危及患者生命，抢救成功率极低。为减少下肢深静脉血栓的发生、降低死亡率，笔者针对下肢骨折患者围术期应用抗凝药物（低分子肝素钙、利伐沙班等）预防下肢骨折深静脉血栓，疗效满意，现报道如下。 　　 　　1 资料与方法 　　1.1 一般资料 　　选择2008年7月～2011年5月152例下肢骨折择期手术的住院患者，其中男62例、女90例，年龄40～7