Clinical trial of aspirin and low molecular weight heparin for prevention of venous thromboembolism in patients with hand and foot trauma fractures after operation
Objective To observe the postoperative effects of aspirin and low-molecular-weight heparin(LMWH)in preventing venous thromboembolism(VTE)and improving distal circulation in patients with hand and foot trauma fractures.Methods Retrospectivey selected patients undergoing hand and foot trauma fracture surgery into control and treatment groups.The control group received enteric-coated aspirin,0.1 g per dose,once daily;the treatment group received subcutaneous injection of calcium-enoxaparin,4 000 U per dose,twice daily,for continuous treatment for 12 days.The incidence of VTE,coagulation function,hemorheological parameters,distal collateral circulation,and drug adverse reactions were compared between the two groups.Results There were 60 patients in each of the treatment and control groups.The incidence of postoperative deep vein thrombosis was 5.00％in the treatment group and 3.33％in the control group,while the incidence of pulmonary embolism was 1.67％in both groups,with no statistically significant differences(all P＞0.05).After treatment,the activated partial thromboplastin time(APTT)in the treatment and control groups were(35.01±5.96)and(36.82±6.15)s,prothrombin time(PT)were(14.95±1.54)and(15.32±1.63)s;fibrinogen(FIB)were(3.97±1.25)and(4.36±1.02)g·L-1;D-dimer(D-D)were(309.69±56.55)and(319.03±55.32)μg·L-1;whole blood viscosity(WBV)were(13.26±3.80)and(12.26±3.61)mPa·s-1;plasma viscosity(PV)were(1.76±0.35)and(1.77±0.43)mPa·s-1,hematocrit(HCT)were(60.20±7.05)％and(58.60±6.71)％,with no statistically significant differences(all P＞0.05).After treatment,the flow rates(Vmax)in the treatment and control groups were(54.27±6.64)and(51.18±5.67)cm·s-1;resistance indices(RI)were 0.59±0.13 and 0.65±0.15,showing statistical significance(all P＜0.05).Comparison of drug adverse reactions such as nausea,vomiting,bleeding,and injection site hematoma between the treatment and control groups showed no statistically significant difference in the overall incidence of adverse drug reactions(P＞0.05).Conclusion There was no significant difference in the efficacy of aspirin and LMWH in preventing postoperative VTE in patients with hand and foot trauma fractures,but LMWH demonstrated better improvement in distal collateral circulation.
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