CAJ | 학술논문

目的：探讨低分子肝素( LMWH)对预防骨盆骨折手术老年患者下肢深静脉血栓的最佳用药时间。方法选取我院骨科收治的骨盆骨折行手术治疗的患者53例，根据术后使用LMWH的时间随机分为6 h组和12h组。观察两组患者术后出血量，术后1、2、7d的大腿与小腿周径差值，术后1、3d的纤维蛋白原与D-二聚体水平，术后1、3 d的凝血功能。结果12 h组患者出血量明显少于6 h组(P<0．01)，术后1、2、7 d的大腿周径差值明显大于6 h组(P<0．05)，术后2、7 d的小腿周径差值明显大于6 h组(P<0．05)，术后3 d的纤维蛋白原水平明显高于6 h组(P<0．01)。两组患者术后3 d的D-二聚体水平比较差异无统计学意义(P>0．05)。12 h组的APTT、PT和TT水平在术前与术后3 d和6 h组比较差异无统计学意义( P>0．05)。结论骨盆骨折手术老年患者术后6 h使用LMWH能够显著降低术后肢体肿胀，降低深静脉血栓的发生率。
목적：탐토저분자간소( LMWH)대예방골분골절수술노년환자하지심정맥혈전적최가용약시간。방법선취아원골과수치적골분골절행수술치료적환자53례，근거술후사용LMWH적시간수궤분위6 h조화12h조。관찰량조환자술후출혈량，술후1、2、7d적대퇴여소퇴주경차치，술후1、3d적섬유단백원여D-이취체수평，술후1、3 d적응혈공능。결과12 h조환자출혈량명현소우6 h조(P<0．01)，술후1、2、7 d적대퇴주경차치명현대우6 h조(P<0．05)，술후2、7 d적소퇴주경차치명현대우6 h조(P<0．05)，술후3 d적섬유단백원수평명현고우6 h조(P<0．01)。량조환자술후3 d적D-이취체수평비교차이무통계학의의(P>0．05)。12 h조적APTT、PT화TT수평재술전여술후3 d화6 h조비교차이무통계학의의( P>0．05)。결론골분골절수술노년환자술후6 h사용LMWH능구현저강저술후지체종창，강저심정맥혈전적발생솔。
Objective To investigate the optimal time of LMWH in preventing thromboembolism of pelvic fractures surgery in gerontal patients. Methods A total of 53 gerontal patients with pelvic fractures surgery were ran-domly divided into 6 h group (6 hours after surgery) and 12 h group (12 hours after surgery) according to the time of postoperative use of LMWH. Postoperative blood loss,diameter difference of thigh and calf at 1,2,7 d after operation, the levels of fibrinogen and D-dimer,blood coagulation function were recorded at 1,3 d after operation. Results The blood loss of 12 h group was less than that of 6 h group (P<0. 01),the thigh diameter difference in 12 h group was significantly greater than that of 6 h group at 1,2,7 d after operation (P<0. 05). The fibrinogen level in 12 h group was obviously higher than that of 6 h group at 3 d after operation (P<0. 01). There was no significant difference in D-dimer levels,APTT levels,PT levels and TT levels between the two groups ( P >0. 05 ) . Conclusion Patients with pelvic fractures surgery using LMWH 6 h after surgery can significantly reduce postoperative limb swelling and the in-cidence of deep vein thrombosis.