低分子肝素预防人工髋、膝关节置换术后下肢深静脉血栓形成的研究

目的 对比观察采用低分子有直素预防人工髋、膝置换术（ＴＨＲ、ＴＫＲ）后下肢深静脉血栓形成（ＤＶＴ）的临床效果。方法 将１９９７掉１１月－１９９９年３月行人工髋膝置换术的患者随机分为未用药组和用药组,其中未用药组共４７例患者,６２例关节置换,未预防性使用低分子肝素抗凝;用药组共３１例患者,３６例关节置换（１９膝,１７髋）,围手术期给予低分子肝素预防治疗。两组患者均于术后行下肢静脉造影检查。结果 用药

Low-molecular-weight heparin for preventing deep-vein thrombosis after total joint arthroplasty

OBJECTIVE: To evaluate the efficacy and safety of low-molecular-weight heparin (LMWH) in preventing deep-vein thrombosis (DVT) after total hip and knee replacement (THR, TKR). METHODS: From November 1997 to March 1999, we performed total joint replacement for 47 control patients (34 knees, 28 hips) and for 31 patients (19 knees, 17 hips) who had been given low-molecular-weight heparin for preventing deep-vein thrombosis. All patients received venography of the operated limbs after operation. RESULTS: DVT occurred in 19.4% of the LMWH patients (26.3% in TKR, 11.8% in THR) and the reduction was significant (P < 0.05) compared to the control group (48.4%, 55.9%, 39.3% respectively). The incidence of proximal DVT was also reduced significantly (P < 0.05) from 19.4% of the control group to 2.8% of the LMWH group. CONCLUSION: Low-molecular-weight heparin can significantly reduce the incidence of deep-vein thrombosis after total joint replacement.