CAJ | 학술논문

目的：探讨人工髋关节置换（THA）术后低分子肝素（LMWH）防治深静脉血栓（DVT）形成的效果及对血液流变学的影响。方法选择2012年6月至2014年6月来该院进行人工髋关节置换术患者620例，按照数字列表法随即平均分为低分子肝素组和常规治疗组，其中常规治疗组患者术后使用常规方法预防深静脉血栓形成，低分子肝素组患者在进行常规预防方法的基础上应用低分子肝素预防深静脉血栓，每天5000 U ，比较两组患者治疗1周后深静脉血栓形成的发生率，以及术后1周血液流变学，其中包括血小板聚集率、纤维蛋白原、全血粘度及血浆粘度。结果（1）低分子肝素组患者深静脉血栓形成的发生率4．84％明显低于常规治疗组的发生率21．94％，比较差异有统计学意义（χ2＝14．87，P＜0．05）。（2）术后1周，低分子肝素组患者治疗后血液流变学，包括血小板聚集率、纤维蛋白原、全血粘度及血浆粘度均明显低于常规治疗组，差异有统计学意义（P＜0．05）。结论人工髋关节置换术后应用低分子肝素，能使深静脉血栓形成的发生率显著降低，并且能够改善患者术后的血液流变学，安全可靠，值得临床推广。
목적：탐토인공관관절치환（THA）술후저분자간소（LMWH）방치심정맥혈전（DVT）형성적효과급대혈액류변학적영향。방법선택2012년6월지2014년6월래해원진행인공관관절치환술환자620례，안조수자렬표법수즉평균분위저분자간소조화상규치료조，기중상규치료조환자술후사용상규방법예방심정맥혈전형성，저분자간소조환자재진행상규예방방법적기출상응용저분자간소예방심정맥혈전，매천5000 U ，비교량조환자치료1주후심정맥혈전형성적발생솔，이급술후1주혈액류변학，기중포괄혈소판취집솔、섬유단백원、전혈점도급혈장점도。결과（1）저분자간소조환자심정맥혈전형성적발생솔4．84％명현저우상규치료조적발생솔21．94％，비교차이유통계학의의（χ2＝14．87，P＜0．05）。（2）술후1주，저분자간소조환자치료후혈액류변학，포괄혈소판취집솔、섬유단백원、전혈점도급혈장점도균명현저우상규치료조，차이유통계학의의（P＜0．05）。결론인공관관절치환술후응용저분자간소，능사심정맥혈전형성적발생솔현저강저，병차능구개선환자술후적혈액류변학，안전가고，치득림상추엄。
Objective To investigate the efficacy and influence to hemorrheology of low molecular weight hep‐arin(low molecular weight heparins ,LMWH) in hip replacement surgery(total hip arthroplasty ,THA) prevention of deep vein thrombosis (deep vein thrombosis ,DVT)formation .Methods 620 cases with hip arthroplasty were select‐ed from our hospital during the period from June 2012 to June 2014 ,they were average divided into the low molecular weight heparin group and the conventional treatment group according to digital List France ,the patients of the con‐ventional treatment group were treated with conventional methods to prevent deep vein thrombosis ,the patients of the low molecular weight heparin group were given low molecular weight heparin in the prevention of deep vein thrombosis based on the conventional method ,5000 U every day ,the incidence of deep vein thrombosis 1 week after treatment of two groups were compared ,and hemorrheology include platelet aggregation ,fibrinogen ,whole blood vis‐cosity and plasma viscosity 1 week after treatment of two groups were compared .Results ① The incidence of deep vein thrombosis of the low molecular weight heparin group was 5 .00% significantly lower than 21 .67% of the con‐ventional treatment group ,the difference was statistically significant(χ2 =14 .87 ,P<0 .05);②hemorrheology inclu‐ding platelet aggregation ,fibrinogen ,whole blood viscosity and plasma viscosity 1 week after treatment of the low molecular weight heparin group significantly lower than the conventional treatment group ,the difference was statisti‐cally significant(P< 0 .05) .Conclusion low molecular weight heparin was used hip arthroplasty can significantly lower the incidence of deep vein thrombosis ,and can improve postoperative blood rheology ,safe and reliable ,was worth to spread in clinical .