皮下注射固定剂量普通肝素预防髋部手术后下肢深静脉血栓形成

目的探讨体重调整固定剂量普通肝素皮下注射预防髋部大手术后下肢深静脉血栓形成的有效性及安全性。方法56例髋部手术后患者,随机分为对照组27例及实验组29例,分别给予低分子量肝素及普通肝素治疗,两药均为术后12～24h皮下注射,每天2次,剂量根据患者体重决定,疗程为7d。记录术中术后输血总量及术后引流量,术后第1天及术后第7天测定血红蛋白、血小板、凝血酶原时间及活化部分凝血活酶时间,计算两组下肢深静脉血栓发生率。结果对照组与实验组输血总量及术后伤口引流液总量差异无显著统计学意义(p>0.05);两组术后第1天及第7天血红蛋白、血小板、凝血酶原时间及活化部分凝血活酶时间变化差异无显著统计学意义(p>0.05);两组患者术后下肢深静脉血栓发生率差异无显著统计学意义(p>0.05)。结论皮下注射固定剂量普通肝素预防髋部手术后下肢深静脉血栓形成安全有效。

SUBCUTANEOUS INJECTION OF FIXED-DOSE WEIGHT ADJUSTED UNFRACTIONATED HEPARIN TO PREVENT DEEP VENOUS THROMBOSIS AFTER HIP OPERATION

Objective To investigate safety and efficacy of fixed-dose weight adjusted unfractionated heparin to prevent deep venous thrombosis (DVT) after hip operation.Methods 56 patients were randomly divided into control group and experimental group.27 cases in control group were treated with subcutaneous low-molecular heparin, while 29 cases in experimental group treated with subcutaneous unfractionated heparin, and both were given twice daily 12 to 24 hours after operation for 7 days.The daily doses were adjusted to patients’ weight.The volume of blood transfused and postoperative blood loss was recorded, and levels of hemoglobin, platelet, prothrombin time and APTT were tested.Incidences of DVT were obtained.Results There was no significant difference in the volume of blood transfused and postoperative blood loss between two groups (p>0.05).There was no significant change of hemoglobin, platelet, prothrombin time and APTT on the first and seventh day after surgery (p>0.05).There was no significant difference in incidences of DVT in two groups (p>0.05).Conclusion Subcutaneous unfractionated heparin can effectively reduce the incidence of DVT after hip operation, and has a good result in treating DVT with low incidence of side effects.