学术论文

      康复训练联合低分子肝素钙对老年人髋部骨折术后功能恢复和静脉血栓的影响

      Impact of rehabilitation training combined with low molecular heparin calcium on functional recovery and venous thrombosis of postoperative period of hip fracture in the elderly

      摘要:
      目的:探讨康复训练联合低分子肝素钙对老年人髋部骨折术后功能恢复和静脉血栓的影响。方法选择行髋部骨折手术的老年患者86例为研究对象,按照随机数字表法分为对照组(43例)和观察组(43例),对照组给予低分子肝素钙,观察组给予低分子肝素钙联合康复训练,4周后观察两组的髋关节功能、静脉血栓发生情况,检测术后及4周的全血高切黏度、中切黏度、低切黏度、红细胞聚集指数等血液流变学指标和凝血酶原时间、D-二聚体凝血功能指标。结果观察组髋关节疼痛、关节功能、关节活动度、畸形等Harris 评分高于对照组,差异均有统计学意义(t =3.713、3.224、3.345、1.861、8.087,均 P <0.05)。观察组静脉血栓发生率6.89%,显著低于对照组的23.26%,差异有统计学意义(χ2=4.440,P =0.035)。治疗4周后观察组患者的全血高切黏度、中切黏度、低切黏度及红细胞聚集指数均低于对照组,差异均有统计学意义(t =2.092、2.590、1.716、3.118,均 P <0.05)。治疗后观察组 D-二聚体低于对照组,而凝血酶原时间高于对照组,差异均有统计学意义(t =7.510、2.151,均 P <0.05)。结论康复训练联合低分子肝素钙可促进老年髋部骨折术后患者的髋关节功能恢复,降低静脉血栓发生率,改善血液流变学指标和凝血功能指标。
      Abstract:
      Objective To study the impact of rehabilitation training combined with low molecular heparin calcium on functional recovery and venous thrombosis of postoperative period of hip fracture in the elderly.Methods 86 elderly patients with hip fracture surgery were divided into the control group(43 cases)and observation group (43 cases)according to random number table method.The control group was given low molecular heparin calcium, and the observation group was given rehabilitation training combined with low molecular heparin calcium.After four weeks,the hip functional recovery and venous thrombosis occurrence were observed in the two groups.The levels of blood rheology indicators such as blood high shear viscosity,shear viscosity,low shear viscosity,erythrocyte aggrega-tion index and coagulant function index of thrombin time and D -dimer were detected.Results The scores of hip joint pain,joint function,joint mobility,deformity and Harris score in the observation group were higher than those in the control group,the differences were statistically significant(t =3.713,3.224,3.345,1.861 and 8.087,all P <0.05).The incidence rate of venous thrombosis in the observation group was 6.89%,which was lower than 23.26%in the control group,the difference was statistically significant (χ2 =4.440,P =0.035).After 4 weeks treatment,the levels of the whole blood high shear viscosity,shear viscosity,low shear viscosity and erythrocyte aggregation index in the observation group were lower than those in the control group,the differences were statistically significant (t =2.092,2.590,1.716 and 2.590,all P <0.05).After treatment,the level of D -dimer in the observation group was lower than that in the control group,and the prothrombin time in the observation group was higher than that in the con-trol group,the differences were statistical significance(t =7.510 and 2.151,all P <0.05).Conclusion The rehabil-itation training combined with low molecular heparin calcium can promote hip joint function recovery of postoperative period of hip fracture in the elderly,reduce the incidence of venous thrombosis,improve blood rheology and blood coagulation function indicators.
      作者: 朱云森 张波
      Author: Zhu Yunsen Zhang Bo
      作者单位: 温岭市第一人民医院骨科, 浙江省温岭,317500
      刊 名: 中国基层医药 ISTIC
      年,卷(期): 2017, 24(6)
      在线出版日期: 2017年3月29日
      基金项目: 浙江省温岭市科技计划项目(2009WLCB0092)Fund programScience and technology planning project of Wenling city,Zhejaing province