| 李攀,刘耀波,吴世鹏,张宝鉴,孙润芳.两种抗凝剂预防老年髋部周围骨折患者围手术期深静脉血栓形成的疗效对比[J].实用中西医结合临床,2021,21(1): |
| 两种抗凝剂预防老年髋部周围骨折患者围手术期深静脉血栓形成的疗效对比 |
| Comparison of the efficacy of two anticoagulants in the prevention of perioperative deep venous thrombosis in elderly patients with around hip fracture |
| 投稿时间：2020-09-06 修订日期：2021-01-18 |
| DOI： |
| 中文关键词: 老年髋部周围骨折 低分子量肝素钙 阿哌沙班 深静脉血栓形成 疗效 安全性 |
| 英文关键词: elderly patients with around hip fracture low molecular weight heparin calcium apixaban DVT curative effect safety |
| 基金项目: |
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| 中文摘要: |
| 目的：对比分析低分子量肝素钙与阿哌沙班预防老年髋部周围骨折患者围手术期深静脉血栓形成(DVT)的疗效性及安全性。方法：收集2018年3月-2020年3月在山西省中医院骨科行手术治疗的老年髋部周围骨折患者共70例，按随机数字表法分为A组（低分子量肝素钙组）和B组（阿哌沙班组），各35例；A组皮下注射低分子量肝素钙 0.4mL Qd，B组口服阿哌沙班 2.5mg Bid。两组术后持续抗凝35天，随访3月，比较两组凝血指标、术后引流量、围手术期DVT及出血事件发生率。结果：（1）两组患者术后与术前相比，PLT、D-二聚体下降，APTT、PT延长，且B组D-二聚体较A组明显下降，相比差异有统计学意义（P<0.05），而两组APTT、PT、PLT相比差异无统计学意义（P>0.05）；（2）两组术后引流量（A组：170.86±126.40mL，B组：175.71±141.39mL）相比差异无统计学意义（P>0.05）；（3）两组患者围手术期DVT发生率对比差异有统计学（P<0.05），其中A组发现DVT患者9例（25.7%），B组发现DVT患者2例（5.7%）；（4）两组患者出血事件发生率相比差异无统计学意义（P>0.05）。结论：与低分子量肝素钙相比，老年髋部周围骨折患者围手术期使用阿哌沙班预防DVT的疗效更佳，且不增加出血风险。 |
| 英文摘要: |
| ABSTRACT Objective：To compare and analyze the efficacy and safety of low molecular weight heparin calcium and apixaban in the prevention of perioperative deep vein thrombosis (DVT) in elderly patients with around?hip fracture. Methods：A total of 70 elderly patients with around hip fracture undergoing surgery in the department of Orthopedics, Shanxi Hospital of Traditional Chinese Medicine from March 2018 to March 2020 were collected and divided into group A (the group of low molecular weight heparin calcium ) and group B (the group of apixaban ) by random number table,35 cases each;Subcutaneous injection of 0.4ml Qd of low molecular weight heparin calcium in group A and oral administration of apixaban 2.5mg Bid in group B;Postoperative anticoagulation in both groups lasted for 35 days, followed up for 3 months,the coagulation function,postoperative total flow,the incidence of DVT and bleeding events during perioperative period were compared between the two groups.Results：After operation, PLT and D-Dimer of the two groups were decreased compared with those before operation, APTT and PT were prolonged after operation, and D-dimer in group B was significantly lower than that in group A (P < 0.05), while there was no significant difference in APTT, PT and PLT between the two groups (P > 0.05);The postoperative total flow (group A :170.86±126.40mL, group B :175.71±141.39mL) showed no statistically significant difference between the two groups（P>0.05）;The incidence of perioperative DVT was statistically different between the two groups(P<0.05) ,Group A, 9 patients (25.7%) were found with DVT,two patients with DVT were found in group B (5.7%);There was no significant difference in the incidence of bleeding events between the two groups（P>0.05）.Conclusion：Compared with low molecular weight heparin calcium, the prevention of perioperative DVT in elderly patients of around hip fracture with apixaban were more effective and did not increase the risk of bleeding. |
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