低分子肝素对下肢骨折患者中心静脉导管相关深静脉血栓的预防效果
Effect of low molecular weight heparin on prevention of central venous catheter related deep venous thrombosis in patients with lower limb fracture
汤海燕 1傅红飞 1傅娜佳 1徐洁丽1
作者信息
- 1. 诸暨市第四人民医院 急诊室,浙江 诸暨 311835
- 折叠
摘要
目的 探讨低分子肝素对下肢骨折患者进行中心静脉导管穿刺后的预防深静脉血栓效果.方法 选取2014年2月~2016年10月诸暨市第四人民医院外科收治的213例经外周静脉穿刺中心静脉置管后发生深静脉血栓的下肢骨折患者进行回顾性分析,根据患者是否使用低分子肝素分为2组,其中未使用低分子肝素患者104例为对照组,使用低分子肝素109例患者为研究组,以治疗7d为观察期,统计分析2组患者的血液流变学指标及深静脉血栓发生情况.结果 治疗后,2组全血高切粘度、全血低切粘度、纤维蛋白原、血浆D-二聚体水平均降低,且研究组显著低于对照组(P<0.05),研究组血浆黏度显著低于对照组(P<0.05);治疗后,研究组的深静脉血栓复发率明显低于对照组(P<0.05);研究组患者的治疗有效率为96.33%明显高于对照组76.92%(P<0.05);研究组不良发应发生率1.83%明显低于对照组7.69%(P<0.05).结论 低分子肝素能够有效改善下肢骨折患者在中心静脉导管穿刺后的血液流变学等指标,降低深静脉血栓的发生风险,有明确的预防作用效果.
Abstract
Objective To investigate the effect of low molecular weight heparin (LMWH) on the prevention of deep venous thrombosis in patients with lower limb fracture.Methods 213 cases of peripherally inserted central venous catheter after deep venous thrombosis of lower extremity fractures from February 2014 to October 2016 in our hospital orthopedic surgery were retrospectively analyzed,according to whether patients with low molecular weight heparin were divided into two groups,which did not use low molecular weight heparin in patients with 104 cases as control group,using the low molecular weight heparin in 109 patients as study group,with seven days of treatment as the observation period, the blood rheology indexes of the two groups of patients and the incidence of deep vein thrombosis were analyzed.Results After treatment, the blood viscosity, fibrinogen, and plasma D-dimer levels of the whole blood decreased in both groups, and the levels of plasma D-dimer were significantly lower in the study group than in the control group (P<0.05);the plasma viscosity of the study group was significantly lower than that of the control group (P <0.05).After treatment,the recurrence rate of deep venous thrombosis in the study group was significantly lower than that in the control group ( P<0.05 ); The effective rate of treatment group was 96.33%was significantly higher than the control group 76.92%(P<0.05);study group incidence of adverse reactions 1.83%was significantly lower than the control group 7.69%( P <0.05 ) .Conclusion Low molecular weight heparin can effectively improve the indexes of Hemorheology in patients with lower limb fracture after central venous catheter puncture, reduce the risk of deep vein thrombosis, and have a clear preventive effect.
关键词
低分子肝素/下肢骨折/中心静导管/深静脉血栓/预防效果Key words
low molecular weight heparin/lower extremity fracture/central venous catheter/deep venous thrombosis/preventive effect引用本文复制引用
出版年
2017
NETL
NSTL
维普
万方数据