老年股骨颈骨折半髋置换围术期依诺肝素的应用.

BACKGROUND: Venous thrombosis is a serious perioperative complication in elderly patients with hip fracture. It is necessary to select an effective intervention program to reduce its risk. OBJECTIVE: To compare the effects of enoxaparin and rivaroxaban on intraoperative hemorrhage and postoperative deep venous thrombosis during perioperative period of hemiarthroplasty in elderly patients with femoral neck fracture. METHODS: A total of 95 patients with femoral neck fractures aged 65 years and older were enrolled in the Department of Orthopedics, Beijing Jiangong Hospital from January 2016 to January 2018. These patients were assigned to two groups. Patients in the control group (n=43) were orally administered rivaroxaban once a day during the perioperative bed rest, and the drug was discontinued once on the operation day. Patients in the trial group (n=52) were given a subcutaneous injection of enoxaparin during the perioperative bed rest, and the drug was stopped 12 hours before the operation. Informed consent was obtained from all patients. This study was approved by the Hospital Ethics Committee. The intraoperative blood loss, postoperative blood loss, perioperative dominant and occult blood loss, postoperative bleeding rate and incidence of postoperative deep venous thrombosis were compared between the two groups. RESULTS AND CONCLUSION: (1) There was no significant difference in the amount of intraoperative blood loss, postoperative blood loss, perioperative dominant blood loss, postoperative bleeding rate, and incidence of postoperative deep venous thrombosis between the two groups (P>0.05). (2) However, the perioperative occult blood loss in the trial group was less than that in the control group (P<0.05). (3) It is suggested that enoxaparin is safe and reliable in the perioperative period of hemiarthroplasty for femoral neck fracture. Compared with rivaroxaban, enoxaparin can reduce the occult blood loss during the perioperative period. [ABSTRACT FROM AUTHOR]