梁宇斌 蔡华昌 宋伟宏

【摘要】 目的：探討髋关节置换术围术期应用那屈肝素钙的临床疗效。方法：选取2019年1月-2020年

1月在本院进行髋关节置换术的患者50例。根据随机数字表法将患者分为对照组和研究组，每组25例。对照组在围术期应用常规干预，包括常规被动锻炼及物理干预，研究组在此基础上应用那屈肝素钙。比较两组的凝血功能及并发症发生情况。结果：术后1、3、7 d，研究组的FIB、D-D水平均低于对照组，APTT、PT时间均长于对照组，差异均有统计学意义（P<0.05）。术后1、3、7 d，两组的血红蛋白水平比较，差异均无统计学意义（P>0.05）;术后1、3、7 d，研究组血小板水平均低于对照组，差异均有统计学意义（P<0.05）。研究组下肢深静脉血栓、肺栓塞的发生率均低于对照组，差异均有统计学意义（P<0.05）。结论：髋关节置换术围术期应用那屈肝素钙取得了满意的效果，能够更好地改善患者的凝血功能，降低下肢深静脉血栓及肺塞栓的发生，值得临床进一步推广应用。

【关键词】 那屈肝素钙 髋关节置换术 围术期

Observation on the Clinical Effect of Nadroparin Calcium in Perioperative Period of Hip Replacement/LIANG Yubin， CAI Huachang， SONG Weihong. //Medical Innovation of China， 2021， 18（14）： 0-059

[Abstract] Objective： To explore the clinical effect of perioperative application of Nadroparin Calcium in hip replacement surgery. Method： A total of 50 patients who underwent hip arthroplasty in our hospital from January 2019 to January 2020 were selected. According to random number table method， the patients were divided into control group and study group， 25 cases in each group. The control group received routine intervention including routine passive exercise and physical intervention during perioperative period， while the study group received Nadroparin Calcium on the basis of this. The coagulation function and complications were compared between the two groups. Result： At 1， 3 and 7 d after operation， the FIB and D-D levels in the study group were lower than those in the control group， and the APTT and PT time were longer than those in the control group， the differences were statistically significant （P<0.05）. At 1， 3 and 7 d after operation， there were no significant differences in hemoglobin levels between the two groups （P>0.05）. At 1， 3 and 7 d after operation， platelet levels in the study group were lower than those in the control group， the differences were statistically significant （P<0.05）. The incidence of deep vein thrombosis and pulmonary embolism in the study group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The perioperative application of Nadroparin Calcium in hip arthroplasty has achieved satisfactory results， which can better improve the coagulation function of patients， reduce the occurrence of lower extremity deep vein thrombosis and pulmonary embolism， and is worthy of further clinical promotion and application.

[Key words] Nadroparin Calcium Hip replacement Perioperative period

First-authors address： Zhanjiang Central Peoples Hospital， Zhanjiang 524000， China

doi：10.3969/j.issn.1674-4985.2021.14.014

髋关节置换术在髋关节疾患治疗中有着极高的应用价值，但是术后患者需卧床、肢体制动，增加了下肢深静脉血栓的发生风险，影响着患者的康复，因此需要通过一定的方法来预防或降低其风险的发生[1]。目前临床中常用的方法是应用抗凝药物及早期锻炼，以往低分子肝素钙的应用最多[2-3]。那屈肝素钙也是低分子肝素的一种，但临床中对其在髋关节置换术围术期应用效果的相关文献较少，本文为探讨髋关节置换术围术期应用那屈肝素钙的临床疗效，现报道如下。

1 资料与方法

1.1 一般资料 选取2019年1月-2020年1月在本院进行髋关节置换术的患者50例。（1）纳入标准：①进行髋关节置换术，且无手术禁忌证;②术前未发生下肢深静脉血栓。（2）排除标准：①凝血功能障碍;②有血栓、血管疾病史;③精神、意识及沟通能力障碍;④心、肺等器官功能严重障碍。……