那屈肝素钙与磺达肝癸钠在预防脊柱骨折患者术后深静脉血栓形成中的应用

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摘要目的探讨那屈肝素钙与磺达肝癸钠在预防脊柱骨折患者术后深静脉血栓（DVT）形成中的应用。方法选取2019年1～6月于我院接受手术治疗的60例脊柱骨折患者作为研究对象，按照随机数字表法分为NC组与FS组，每组各30例。NC组早期给予那屈肝素钙，FS组早期给予磺达肝癸钠，另选取同期入院体检的35例健康志愿者作为对照组。比较NC组与FS组的DVT发生率；比较三组的凝血功能指标[活化部分凝血活酶时间（APTT）、血小板计数（PLT）、纤维蛋白原（Fib）、D-二聚体（D-D）、抗凝血酶Ⅲ（AT-Ⅲ）]、血液流变学指标[全血低切黏度（LWBV）、全血高切黏度（HWBV）、红细胞比容（HCT）、红细胞沉降率（ESR）、血小板聚集率（PAR）]、下肢静脉血流速度（双侧下肢股静脉和腘静脉）；比较NC组与FS组的药物不良反应发生率及住院时间。结果 NC组与FS组的DVT发生率比较，差异无统计学意义（P＞0.05）。NC组与FS组的APTT 短于对照组，Fib、D-D水平高于对照组，NC组AT-Ⅲ水平明显低于FS组和对照组，差异均有统计学意义（P＜0.05）；三组的PLT 比较，差异无统计学意义（P＞0.05）。三组的LWBV、HWBV、HCT、ESR和PAR 比较，差异无统计学意义（P＞0.05）。三组的左侧股静脉、右侧股静脉、左侧腘静脉和右侧腘静脉血流速度比较，差异无统计学意义（P＞0.05）。NC组和FS组的切口出血、其他部位出血、贫血/血小板减少、恶心/呕吐发生率及住院时间比较，差异无统计学意义（P＞0.05）。结论脊柱骨折患者术后预防性应用那屈肝素钙或磺达肝癸钠均可改善凝血功能指标，不影响患者的血液流变学指标，不增加患者的DVT和药物不良反应发生率，临床应根据患者情况选择用药。

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	童剑萍

关键词 ：那屈肝素钙, 脊柱骨折, 深静脉血栓, 预防, 磺达肝癸钠

Abstract：Objective To investigate the application of Nadroparin Calcium and Fondaparinux Sodium in preventing deep vein thrombosis (DVT) of patients with spinal fractures.Methods Sixty patients with spinal fractures who underwent surgical treatment in our hospital from January to June 2019 were selected as the research subjects,they were divided into NC group and FS group according to the random number table method,with 30 cases in each group.The NC group was given Nadroparin Calcium early,the FS group was given Fondaparinux Sodium early,and another 35 healthy volunteers who were admitted for physical examination during the same period were selected as the control group.The incidence of DVT was compared between NC group and FS group.The three groups were compared in terms of coagulation indexes (activated partial thromboplastin time[APTT],platelet count[PLT],fibrinogen[FIB],D-dimer[D-D],antithrombin Ⅲ[AT-Ⅲ]),hemorheology indexes (low-cut viscosity of whole blood [LWBV],high-cut viscosity of whole blood [HWBV],hematocrit[HCT],[erythrocyte sedimentation rate[ESR],platelet aggregation rate[PAR]),blood flow velocity of lower extremity vein (bilateral femoral vein and popliteal vein of lower extremity).The incidence of adverse drug reactions and hospitalization time were compared between NC group and FS group.Results There was no significant difference in DVT incidence between NC group and FS group (P＞0.05).The APTT of the NC group and the FS group was shorter than that of the control group,the levels of Fib and D-D were higher than those of the control group,the AT-Ⅲlevels of the NC group were significantly lower than those of the FS group and the control group,the differences were statistically significant (P＜0.05).There was no significant difference in PLT comparison among the three groups (P＞0.05).There were no significant differences in blood flow velocity of LWBV,HWBV,HCT,ESR and PAR among the three groups (P＞0.05).There were no significant differences in the left femoral vein,right femoral vein,left iliac vein,and right iliac vein among the three groups (P＞0.05).There were no significant differences in the incidence of incision bleeding,bleeding at other sites,anemia/thrombocytopenia,nausea/vomiting,and length of hospital stay in the NC and FS groups (P＞0.05).Conclusion The preventive application of Nadroparin Calcium or Fondaparinux Sodium in patients with spinal fracture after operation can improve the coagulation index,not affect the hemorheology index of patients,not increase the incidence of DVT and adverse drug reactions of patients.The clinical use of Nadroparin Calcium or Fondaparinux Sodium should be based on the situation of patients.

Key words： Nadroparin Calcium Spinal fractures Deep vein thrombosis Prevention Fondaparinux Sodium

引用本文:

童剑萍. 那屈肝素钙与磺达肝癸钠在预防脊柱骨折患者术后深静脉血栓形成中的应用[J]. 中国当代医药, 2020, 27(5): 88-91.
TONG Jian-ping. Application of Nadroparin Calcium and Fondaparinux Sodium in preventing deep vein thrombosis of patients with spinal fractures. 中国当代医药, 2020, 27(5): 88-91.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I5/88

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