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早期与延迟应用低分子肝素预防骨盆-髋臼创伤性血栓-一项前瞻性研究。

Early versus delayed thromboprophylaxis with LMWH in pelvic-acetabular trauma- a prospective study.

机构信息

Senior Resident, Department of Orthopaedics, PGIMER, Chandigarh, INDIA.

Professor, Department of Orthopaedics, PGIMER, Chandigarh, INDIA.

出版信息

Injury. 2022 Feb;53(2):529-533. doi: 10.1016/j.injury.2021.09.047. Epub 2021 Oct 2.

Abstract

BACKGROUND

Delayed presentation of pelvic-acetabular fractures is a common scenario in developing countries and there is usually a delay of more than 24 h in their presentation.

OBJECTIVES

We aim to comparatively analyse early(<24 h) versus delayed (>24 h) thromboprophylaxis with low molecular weight heparin (LMWH) in prevention of deep venous thrombosis (DVT) in Pelvic Acetabular fractures.

METHODS

Patients of pelvic-acetabular fractures who presented during 1 year of study period were divided into 2 groups after exclusion of patients with contraindications for thromboprophylaxis. Group A included patients who received LMWH prophylaxis within 24 h of injury. Group B included patients who received LMWH prophylaxis after 24 h of injury. All patients underwent CT venography at day 14 and were followed up with doppler ultrasound on 4th and 8th week.

RESULTS

110 patients with pelvic-acetabular fractures were included after exclusion of 61 patients. 4 out of 29 patients in group A (13.8%) and 12 out of 81 patients (14.8%) in group B developed DVT. There was no significant difference in incidence of DVT between Group A and B (P value-0.893).

CONCLUSION

There was no difference between early and delayed thromboprophylaxis with LMWH in pelvic-acetabular trauma.

摘要

背景

在发展中国家,骨盆髋臼骨折的延迟就诊较为常见,通常会延迟 24 小时以上。

目的

我们旨在比较分析早期(<24 小时)与延迟(>24 小时)使用低分子肝素(LMWH)预防骨盆髋臼骨折深静脉血栓形成(DVT)的效果。

方法

排除禁忌证的患者后,我们将研究期间 1 年内就诊的骨盆髋臼骨折患者分为两组。A 组患者在受伤后 24 小时内接受 LMWH 预防治疗,B 组患者在受伤后 24 小时后接受 LMWH 预防治疗。所有患者在第 14 天接受 CT 静脉造影检查,并在第 4 周和第 8 周进行多普勒超声检查。

结果

排除 61 例患者后,共纳入 110 例骨盆髋臼骨折患者。A 组 29 例患者中有 4 例(13.8%)和 B 组 81 例患者中有 12 例(14.8%)发生 DVT。A 组和 B 组 DVT 的发生率无显著差异(P 值-0.893)。

结论

骨盆髋臼创伤中,早期和延迟使用 LMWH 预防血栓形成的效果没有差异。

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