摘要
目的分析高龄患者股骨粗隆间骨折手术后出现小腿肌间静脉血栓的危险因素和治疗效果。方法将2015年1月-2017年1月收治的73例老年股骨粗隆间骨折患者,依据手术后是否出现小腿肌间静脉血栓,分为血栓组和非血栓组,探讨小腿肌间静脉血栓形成的危险因素、检查指标和治疗转归。结果两组患者的年龄、性别、术前准备时间、D-二聚体、纤维蛋白原(Fibrinoge,FIB)等无明显统计学差异,手术后出现小腿肌间静脉血栓27例,发生率为37.0%,经规范低分子肝素抗凝治疗后,所有患者小腿肌间静脉血栓均无近端扩展,无牙龈出血、脑出血、肉眼血尿以及便血等出血性事件。3例患者出现轻度呼吸困难,肺动脉CTA检查阴性。结论高龄患者股骨粗隆间骨折术后出现小腿肌间静脉血栓比例较高,但与患者年龄、性别、术前准备时间、D-二聚体、纤维蛋白原等并无直接关系,只要经过规范低分子肝素抗凝治疗,导致致命性肺栓塞的可能性非常小。
Objective To observe the risk factors and therapeutic effect of calf intermuscular vein thrombosis in elderly patients with intertrochanteric fracture. Methods A retrospective review of 73 patients with intertrochanteric fractures in the elderly patients from January 2015 to January 2017 in our hospital was performed. According to whether there was calf intermuscular thrombosis after surgery, the patients were divided into a thrombus group and a non-thrombus group. Risk factors for calf intermuscular vein thrombosis, examination of indicators and treatment outcomes were discussed. Results There were no significant differences in age, gender, preoperative preparation time, D-dimer, fibrinogen,etc. There were 27 cases of calf intermuscular vein thrombosis after operation, the incidence rate was37.0%. After anticoagulant therapy with low molecular weight heparin, all patients had no proximal expansion of the calf intermuscular vein thrombosis and asymptomatic pulmonary embolism. All the patients had no gingival bleeding, cerebral hemorrhage, hematuria and hemafecia and other hemorrhagic events. Three Patients had mild dyspnea, with negative pulmonary arterial CTA test. Conclusion The incidence of calf intermuscular vein thrombosis is higher in elderly patients with intertrochanteric fractures, but the possibility of fatal pulmonary embolism is very small after regular low molecular weight heparin anticoagulation.
作者
底垚宗
DI Yaozong(Department of Joint Surgery,Beijing Pinggu Hospital,Beijing,101200,China)
出处
《实用手外科杂志》
2019年第4期422-425,共4页
Journal of Practical Hand Surgery
关键词
股骨粗隆间骨折
肌间静脉血栓
肺栓塞
Intertrochanteric fractur
Muscular calf vein thrombosis
Pulmonary embolism
作者简介
底垚宗(1982-),男,主治医师.
