| 超早期间歇充气加压预防老年转子间骨折术后下肢深静脉血栓形成的病例对照研究 |
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投稿时间：2011-08-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 厉驹 |
LI Ju |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics, Hospital of TCM of Zhejiang Provice, Hangzhou 310006, Zhejiang, China |
dliju@yahoo.cn |
| 吴刚 |
WU Gang |
富阳市第二人民医院骨科 |
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| 季卫锋 |
JI Wei-feng |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics, Hospital of TCM of Zhejiang Provice, Hangzhou 310006, Zhejiang, China |
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| 童培建 |
TONG Pei-jian |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics, Hospital of TCM of Zhejiang Provice, Hangzhou 310006, Zhejiang, China |
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| 期刊信息：《中国骨伤》2012年，第25卷，第1期，第32-34页 |
| DOI：10.3969/j.issn.1003-0034.2012.01.009 |
| 基金项目: |
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中文摘要:
目的：评价超早期间歇充气加压(intermittent pneumatic compression,IPC)治疗预防老年股骨转子间骨折术后下肢深静脉血栓形成的疗效。
方法：对2008年5月至2010年5月收治的80例老年股骨转子间骨折患者分为超早期组和术后组,各40例,其中超早期组男21例,女19例,年龄67～86岁,平均(76.4±13.27)岁；术后组男26例,女14例,年龄68～89岁,平均(75.8±12.71)岁。超早期组为术前3 d开始使用IPC,术后组术后当天开始使用IPC.分别测定患者术前第3天,术后第3、7、14天血清D-二聚体(D-D)浓度。术前第3天,术后第3、14天通过双下肢深静脉超声检查患者DVT发生情况。记录两组患者的围手术期出血量
结果：两组患者术前第3天血清D-D浓度及双下肢DVT发生情况差异无统计学意义,两组患者围手术期出血量差异无统计学意义。超早期组术后第3、7天血清D-D浓度分别为(351.00±104.34)、(412.31±106.95) μg/ml,比术后组(419.34±145.38)、(509.16±146.05) μg/ml低；术后第14天,两组患者血清D-D浓度差异无统计学意义。两组患者术后第3天DVT发生率分别为7.5%、12.5%,差异无统计学意义；术后第14天术后组DVT发生率为22.5%,高于超早期组。
结论：与术后开始使用IPC相比,超早期使用IPC在不增加老年转子间骨折围手术期出血量的情况下可降低患者术后血清D-D浓度水平,并能降低DVT的发生率。 |
| 【关键词】髋骨折 静脉血栓形成 间歇充气加压 D-二聚体 病例对照研究 |
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| Case-control study on ultra-early application with intermittent pneumatic compression to prevent postoperative deep venous thrombosis of intertrochanteric femoral fracture in elderly patients |
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ABSTRACT
Objective: To evaluate the clinical effects of ultra-early application with intermittent pneumatic compression (IPC) in preventing postoperative lower limbs deep venous thrombosis(DVT)of intertrochanteric fractures in elder patients.
Methods: From May 2008 to May 2010,80 patients with intertrochanteric fractures were randomly divided into ultra-early group and postoperative group. In ultra-early group,there were 21 males and 19 females,ranging in age from 67 to 86 years with an average of(76.4±13.27) years;in postoperative group,there were 26 males and 14 females,ranging in age from 68 to 89 years with an average age (75.8±12.71) years. IPC was respectively used at the 3rd day before operation (ultra-early group) and postoperative that day(postoperative group). Serum D-dimer of all the patients were measured at the 3rd day before operation and at the 3rd,7th,14th days after operation. Lower limbs DVT were observed by ultrasound at the 3rd,14th days postoperatively. Perioperative bleeding volume of patients were compared between two groups.
Results: There was no statistical difference in the serum D-dimer concentration and lower limbs DVT between two groups at the 3rd day before operation (P>0.05). There was no statistical difference in perioperative bleeding volume between two groups(P>0.05). In ultra-early group,Serum D-dimer concentration at the 3rd,7th days after operation was respectively(351.00±104.34),(412.31±106.95) μg/ml;and in postoperative group,the item was respective(419.34±145.38),(509.16±146.05) μg/ml;serum D-dimer concentration in ultra-early group was lower than postoperative group(P<0.05). There was no significant differences in serum D-dimer concentration at the 14th day after operation between two groups (P>0.05). Incidence of DVT in postoperative group was 22.5%,which was higher than that of ultra-early group at the 14th day after operation (P<0.05). There was no significant differences at the 3rd day after operation between two groups (P>0.05).
Conclusion: Compared with postoperative application with IPC,ultra-early application with IPC could reduce the level of serum-dimer and the incidence of DVT without increase perioperative blood of intertrochanteric fracture in elder patients. |
| KEY WORDS Hip fractures Venous thrombosis Intermittent pneumatic compression D-dimer Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 厉驹,吴刚,季卫锋,童培建.超早期间歇充气加压预防老年转子间骨折术后下肢深静脉血栓形成的病例对照研究[J].中国骨伤,2012,25(1):32~34 |
| 英文格式: | LI Ju,WU Gang,JI Wei-feng,TONG Pei-jian.Case-control study on ultra-early application with intermittent pneumatic compression to prevent postoperative deep venous thrombosis of intertrochanteric femoral fracture in elderly patients[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(1):32~34 |
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