Steele N, Dodenhoff R M, Ward A J, Morse M H
Frenchay Hospital, Bristol, England.
J Bone Joint Surg Br. 2005 Feb;87(2):209-12. doi: 10.1302/0301-620x.87b2.14447.
We prospectively studied the outcome of a protocol of prophylaxis for deep vein thrombosis (DVT) in 103 consecutive patients undergoing surgical stabilisation of pelvic and acetabular fractures. Low-molecular-weight heparin (LMWH) was administered within 24 hours of injury or on achieving haemodynamic stability. Patients were screened for proximal DVT by duplex ultrasonography performed ten to 14 days after surgery. The incidence of proximal DVT was 10% and of pulmonary embolus 5%. Proximal DVT developed in two of 64 patients (3%) who had received LMWH within 24 hours of injury, but in eight of 36 patients (22%) who received LMWH more than 24 hours after the injury (p < 0.01). We conclude that LMWH, when begun without delay, is a safe and effective method of thromboprophylaxis in high-risk patients with major pelvic or acetabular fractures.
我们前瞻性地研究了103例连续接受骨盆和髋臼骨折手术固定患者的深静脉血栓形成（DVT）预防方案的结果。在受伤后24小时内或血流动力学稳定后给予低分子量肝素（LMWH）。术后10至14天通过双功超声对患者进行近端DVT筛查。近端DVT的发生率为10%，肺栓塞的发生率为5%。在受伤后24小时内接受LMWH的64例患者中有2例（3%）发生近端DVT，但在受伤后超过24小时接受LMWH的36例患者中有8例（22%）发生近端DVT（p<0.01）。我们得出结论，对于骨盆或髋臼严重骨折的高危患者，及时开始使用LMWH是一种安全有效的血栓预防方法。
