围手术期不同抗凝药物对高龄股骨粗隆间骨折隐性失血和深静脉血栓的影响分析

目的目的分析比较高龄股骨粗隆间骨折围手术期使用不同抗凝药物对隐性失血和深静脉血栓的影响。方法回顾性分析我科2002年1月～2011年1月采取股骨近端防旋髓内钉（PFNA）治疗的82例股骨粗隆间骨折患者资料。按照抗凝药物分为两组,对照组（33例）围手术期每天给予阿司匹林100mg口服,试验组（49例）围手术期每天给予低分子肝素4 250U皮下注射。使用Gross方程,计算围手术期失血量。结果对照组和试验组隐性出血量分别为（153.12±7.18）ml、（109.19±10.81）ml,P〈0.05,差异有统计学意义;两组患者下肢深静脉血栓发生率分别为6.06%和6.12%,无统计学差异。结论股骨粗隆间骨折应用低分子肝素对患者隐性失血影响较小,合理选用抗凝药物有利于减少围手术期失血量。

Impact of different anticoagulant drugs on hidden blood loss and deep venous thrombosis in the peri-operative period in elderly patients with femoral intertrochanteric fractures

Objective To evaluate the impact of different anticoagulant drugs on hidden blood loss and deep venous thrombosis during the peri-operative period in elderly patients with femoral intertrochanteric fractures.Methods Totally 82 cases of elderly intertrochanteric fractures were retrospectively analyzed,who were treated with proximal femoral nail antirotation(PFNA) from Jan.2002 to Jan.2011.The cases were divided into 2 groups.The 33 cases in the control group were treated with aspirin(100 mg/day),and 49 cases in the trial group with low molecular weight heparin(4250 U/day).Gross formula was applied to calculate the volumn of blood loss in the perioperative period.Results The volume of hidden blood loss was(153.12±7.18)ml in the control group and(109.19±10.81)ml in the trial group,showing significant difference(P<0.05);the deep venous thrombosis rate was 6.06% in the control group and 6.12% in the trial group,showing no significant difference.Conclusion The low molecular weight heparin in treating femoral intertrochanteric fractures has little effect on the hidden blood loss.It is important to choose ideal anticoagulant drug so as to reduce the blood loss volume in the peri-operative period.