围手术期髋部骨折患者下肢深静脉血栓发生的时间规律研究

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Abstract Objective To study the temporal pattern of deep venous thrombosis of the lower limb in patients with perioperative hip fractures，and to provide the basis for the prevention of clinical thrombosis.Methods From June 2013 to June 2016，398 cases of femoral fractures (178 cases of femoral neck fractures and 220 cases of intertrochanteric fractures) were divided into anticoagulant group and non-anticoagulation group according to the different anticoagulation time.The patients with hip fractures treated by traumatic orthopedic surgery in Chengde Medical College Hospital All patients were treated with lower extremity venous Doppler ultrasonography on the 1st，3rd，5th day after injury，more than 5 days after injury and on the 2nd，5th，7th and 14th day after operation.The time of thrombosis and the different groups Number of thrombosis cases.The number of new cases of thrombosis and the incidence rate were analyzed statistically at different time points.The frequency distribution curve was used to analyze the peak time of perioperative thrombosis.Results 398 cases were taken in the study.The LMWH prophylaxis thrombosis before operation group were 226 cases，24 cases were diagnosed as deep vein thrombosis(DVT)，and the incidence was 10.61％.The non-LMWH prophylaxis thrombosis before operation group had 172 cases，and 37 cases were diagnosed deep vein thrombosis (DVT)，and the incidence was 21.5％.The difference between two group was significant.The numbers of the LMWH prophylaxis thrombosis before operation group of the DVT at the first day after trauma，the third day，the fifth day and more than the fifth day after trauma.，the second day，the fifth day，the seventh day，the fourteenth day post-operative were 2(0.88％)、6(2.65％)、3(1.33％)、2(0.88％)、9(3.98％)、2(0.88％)、0(0％)、0(0％) respectively.The numbers of the non-LMWH prophylaxis thrombosis before operation group of the DVT at the first day after trauma，the third day，the fifth day and more than the fifth day after trauma，the second day，the fifth day，the seventh day，the fourteenth day post-operative were were3(1.74％)、9(5.23％)、3(1.74％)、4(2.33％)、11(6.40％)、4(2.33％)、1(0.58％)、2(1.16％)respectively，the incidence of DVT at the first three day after injury and the first day after operation were hightest.Conclusion In hip fractures patients，thrombosis occurred within 3 days after injury and one day after surgery.Timely application of drug prevention can reduce the perioperative fractures of patients with perioperative lower extremity venous thrombosis rate.

Key words： hip intertrochanteric fracture femoral neck fracture deep venous thrombosis temporal distribution

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	Wei Junqiang 1
	Sun Hao 1
	Liu Lirui 2
	et al

Cite this article:

Wei Junqiang 1,Sun Hao 1,Liu Lirui 2, et al. Time Course of Perioperative Deep Venous Thrombosis of Lower Extremity Limb in Osteoporotic Hip Fracture in Senile Patients[J]. sygkzz, 2017, 23(11): 991-999.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2017/V23/I11/991

［1］魏俊强，王新宇，金宇，等.利伐沙班对股骨转子间骨折术后失血风险和深静脉血栓形成效果及安全性研究［J］.解放军医药杂志，2015，27(10)：95-98.
［2］张辉良，梁俊生，张洪斌.不同药物对预防骨折围手术期下肢深静脉血栓形成的对比［J］.实用医学杂志，2012，28(2)：293-294.
［3］中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南［J］.中华骨科杂志，2009，29(6)：602-604.
［4］唐颖，郭庆山，赵玉峰，等.创伤骨折并发下肢深静脉血栓的危险因素分析［J］.中华创伤杂志，2010，26(12)：1122-1125.
［5］Roach RE，Lijfering WM，van Hylckama Vlieg A，et al.The risk of venous thrombosis in individuals with a history of superficial vein thrombosis and acquired venous thrombotic risk factors［J］.Blood，2013，122(26)：42644269.［6］Protty MB，Aithal S，Hickey B，et al.Mechanical prophylaxis after hip fracture：what is the risk of deep vein thrombosis? A retrospective observational study［J］.BMJ Open，2015，5(2)：1-5.
［7］肖湘，冯凯强，袁宇，等.老年骨质疏松性髋部骨折患者术前下肢深静脉血栓患病率及危险因素分析［J］.中华骨科杂志，2015，35(11)：1084-1090.
［8］王强，盛伟斌，姜曙祥，等.老年髋关节周围骨折应用低分子肝素预防下肢深静脉血栓的研究［J］.中国骨与关节损伤杂志，2015，25(2)：164-165.
［9］张时文，李宣明.全髋关节置换术和人工股骨头置换术治疗高龄股骨颈骨折的疗效比较［J］.中华创伤杂志，2014，20(7)：692-694.
［10］李春根，陈江，牟明威，等.人工股骨头置换术治疗高龄股骨颈骨折的疗效分析［J］.中华关节外科杂志(电子版)，2011，5(4)：509-512.
［11］彭志平，林云.彩超对下肢深静脉血栓筛查的意义［J］.中国超声医学杂志，2013，29(2)：167-169.
［12］中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南(第2版)［J］.中华外科杂志，2012，50(7)：611-614.
［13］陆芸，马宝通，郭若霖，等.骨科创伤患者深静脉血栓危险因素的研究［J］.中华骨科杂志，2007，27(9)：693-698.
［14］付亚辉，王鹏飞，王宝辉，等.老年髋部骨折患者围手术期深静脉血栓形成的发生规律及血浆D-二聚体的变化特点［J］.中华创伤骨科杂志，2016，18(8)：668-672.
［15］Smith EB，Parvizi J，Purtill JJ.Delayed surgery for patients with femur and hip fractures-risk of deep venous thrombosis［J］.J Trauma，2011，70(6)：113-116.
［16］Swanson E.Ultrasound screening for deep venous thrombosis detection：a prospective evaluation of 200 plastic surgery outpatients［J］.Plast Reconstr Surg Glob Open，2015，3(3)：e332.
［17］Fulvio Pomero F，Dentali F，Borretta V，et al.Accuracy of emergency physician-performed ultrasonography in the diagnosis of deep-vein thrombosis：a systematic review and meta-analysis［J］.Thromb Haemost，2013，109(1)：137-145.
［18］Hill J，Treasure T.Guideline development group.Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital：summary of the NICE guideline［J］.Heart，2010，96(11)：879-882.
［19］李涛，吕明，李庆涛.综合防治法预防老年人股骨近端骨折下肢深静脉血栓形成的比较研究［J］.中国修复重建外科杂志，2008，22(4)：453-455.