术前牵引对粗隆间骨折术后DVT发生的影响(1)
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[摘要] 目的 评估术前应用胫骨结节牵引对粗隆间骨折患者术后深静脉血栓形成的影响。方法 回顾粗隆间骨折患者144例，均为单侧，分为术前牵引组和未牵引组，术前牵引组采用胫骨结节牵引3～5d后手术治疗，未牵引组完成必要检查后即行手术，术后应用常规抗凝治疗，第8天行双侧多普勒超声扫描，观察深静脉血栓形成情况。结果 术前牵引组7例发现DVT形成，DVT发生率9.86%；未牵引组8例发现DVT形成，DVT发生10.96%，两组间比较差异无统计学意义(P>0.05)。结论 术前牵引对术后DVT发生率无明显影响。
[关键词] 牵引；粗隆间骨折；深静脉血栓
[中图分类号] R683.42[文献标识码] B[文章编号] 1673-9701(2011)27-143-02
The Effect of Preoperative Traction to Incidence Rate of DVT after Intertrochanteric Fracture Operation
LI Songbai1 YAN Yihua2 DENG Qingjiang1
1.8730 Army Hospital of CAPF，Guangzhou 510800，China；2.Zhuzhou 331 Hospital，Zhuzhou 412100，China
[Abstract] Objective To evaluate the effect of preoperative tibial tubercle traction to incidence rate of DVT after intertrochanteric fracture operation. Methods All 144 intertrochanteric fracture patients we studied，all in one side，were distributed to two groups，traction group and non-traction group. The patients of traction group were operated after three to five days’ tibial tubercle traction. The patients of non-traction group were operated after necessary medical examination. Conventional anticoagulant therapy were applied to all patients. Deep venous thrombosis was detected by Doppler ultrasound at the eighth day. Results Seven patients were detected DVT after operation in traction group，and the incidence rate was 9.86%. Eight patients were detected DVT after operation in non-traction group，and the incidence rate was 10.96%. There was no significant difference between traction group and non-traction group(P>0.05). Conclusion It is no effect to incidence rate of DVT after operation whether the pateints given preoperative traction or not.
[Key words] Traction；Intertrochanteric fracture；DVT
粗隆间骨折是临床上常见的一类骨折，多发于老年患者，深静脉血栓(deep venous thmmbosis，DVT)是髋部骨折后较常见的一类并发症，严重者可发生严重的肺栓塞。关于术前骨牵引是否应在粗隆间骨折应用仍有争议，为了解术前牵引对DVT发生率的影响，我们对2008年3月～2011年6月医院收治的144例粗隆间骨折患者进行了回顾性研究，现报道如下。
1资料与方法
1.1一般资料
收集2008年3月～2011年6月粗隆间骨折患者144例，均为单侧。分为术前牵引组和未牵引组。其中术前牵引组男23例，女48例，平均年龄(60.73±4.16)岁；未牵引组男24例，女49例，平均年龄(61.5±5.12)岁。术前牵引组和未牵引组在年龄(t检验，P>0.05)、性别(χ2检验，P>0.05)、原发疾病及内科疾病构成(Wilcoxon秩和检验 ......
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