Objective To evaluate the efficacy and safety of low molecular weight heparin (LMWH) prophylaxis for venous thromboembolism (VTE) after lumbar decompression surgery. Methods Patients at high or the highest risk of VTE...Objective To evaluate the efficacy and safety of low molecular weight heparin (LMWH) prophylaxis for venous thromboembolism (VTE) after lumbar decompression surgery. Methods Patients at high or the highest risk of VTE who underwent lumbar spine surgery in Peking Union Medical College Hospital from January 2004 to April 2011 were included in the present study. All the patients received a half dose of LMWH 6 hours after surgery followed by a full dose LMWH once per day until discharge. We recorded incidences of deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding complications, and medication side effects. Results Seventy-eight consecutive patients were eligible and enrolled in this study. The mean hospital stat was 8.5±4.5 days. No symptomatic DVT, PE, or major bleeding events were observed. One patient developed wound ecchymosis, another developed wound bleeding, four had mild hepatic aminotransferase level elevation, and one developed a suspicious allergic reaction. Conclusion LMWH may be applied as an effective and safe prophylaxis for VTE in high-risk patients undergoing lumbar decompression surgery.展开更多
目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗...目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗。比较两组DVT发生情况、下肢深静脉血流速度、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、Harris评分、生活质量评分。结果治疗组的DVT发生率6.67%低于对照组的24.44%(P<0.05)。治疗组治疗后的下肢深静脉血流速度(19.93±1.66)cm/s比对照组的(17.05±1.37)cm/s更快(P<0.05)。治疗组治疗后的PT(12.93±1.16)s、APTT(34.12±3.08)s、TT(14.47±1.21)s长于对照组的(11.24±0.99)、(30.67±2.73)、(13.54±1.12)s,FIB(2.59±0.22)g/L低于对照组的(3.36±0.30)g/L(P<0.05)。治疗组与对照组治疗前后FBG、2 h PBG水平比较均无差异(P>0.05)。治疗组治疗后的Harris评分(76.39±7.30)分比对照组的(65.81±6.25)分更高(P<0.05)。治疗组治疗后的生活质量评分(71.49±6.81)分比对照组的(60.25±5.69)分更高(P<0.05)。结论对髋关节置换术患者使用低分子肝素钙结合物理疗法,可以通过改善体内的高凝状态促进下肢深静脉的血液循环,从而有效预防DVT,对于恢复髋关节功能、提高患者的生活质量具有重要的作用,值得临床推广。展开更多
文摘Objective To evaluate the efficacy and safety of low molecular weight heparin (LMWH) prophylaxis for venous thromboembolism (VTE) after lumbar decompression surgery. Methods Patients at high or the highest risk of VTE who underwent lumbar spine surgery in Peking Union Medical College Hospital from January 2004 to April 2011 were included in the present study. All the patients received a half dose of LMWH 6 hours after surgery followed by a full dose LMWH once per day until discharge. We recorded incidences of deep venous thrombosis (DVT), pulmonary embolism (PE), bleeding complications, and medication side effects. Results Seventy-eight consecutive patients were eligible and enrolled in this study. The mean hospital stat was 8.5±4.5 days. No symptomatic DVT, PE, or major bleeding events were observed. One patient developed wound ecchymosis, another developed wound bleeding, four had mild hepatic aminotransferase level elevation, and one developed a suspicious allergic reaction. Conclusion LMWH may be applied as an effective and safe prophylaxis for VTE in high-risk patients undergoing lumbar decompression surgery.
文摘目的分析低分子肝素钙结合物理疗法对髋关节置换术后下肢深静脉血栓形成(DVT)的预防效果。方法90例实施髋关节置换术的患者,按抽签方法分为对照组和治疗组,各45例。对照组应用物理疗法治疗,治疗组则在对照组基础上应用低分子肝素钙治疗。比较两组DVT发生情况、下肢深静脉血流速度、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、Harris评分、生活质量评分。结果治疗组的DVT发生率6.67%低于对照组的24.44%(P<0.05)。治疗组治疗后的下肢深静脉血流速度(19.93±1.66)cm/s比对照组的(17.05±1.37)cm/s更快(P<0.05)。治疗组治疗后的PT(12.93±1.16)s、APTT(34.12±3.08)s、TT(14.47±1.21)s长于对照组的(11.24±0.99)、(30.67±2.73)、(13.54±1.12)s,FIB(2.59±0.22)g/L低于对照组的(3.36±0.30)g/L(P<0.05)。治疗组与对照组治疗前后FBG、2 h PBG水平比较均无差异(P>0.05)。治疗组治疗后的Harris评分(76.39±7.30)分比对照组的(65.81±6.25)分更高(P<0.05)。治疗组治疗后的生活质量评分(71.49±6.81)分比对照组的(60.25±5.69)分更高(P<0.05)。结论对髋关节置换术患者使用低分子肝素钙结合物理疗法,可以通过改善体内的高凝状态促进下肢深静脉的血液循环,从而有效预防DVT,对于恢复髋关节功能、提高患者的生活质量具有重要的作用,值得临床推广。
