The Perioperative Application Of Low Molecular Weight Heparin In Preventing Deep Vein Thrombosis For Elderly Patients With Hip Fracture

Objective: To evaluate the efficacy and safety of Low Molecular weight Heparin (LMWH) in preventing lower limb deep veins thrombosis (DVT)for elderly patients with hip fracture. Method: Selected 70 elderly patients (age more than 60 year) with hip fracture were randomly divided into two groups, one group included 38 patients was acted as the control-group and only Physical management was used. The other included 32 patients was as the trial-group, and Physical management and LMWH was given for prevention of DVT in pre and postoperation. All patients received Blood routine examination and 4 test items of blood coagulation on admission, preoperation and 1 day, 10 days in postoperation. The Color Doppler Ultrasonography examination was performed on admission, preoperation and 10 days, 1 month,3 months in postoperation, respectively. The amount of blood loss and postoperative drainage between the two groups were recorded and compared. Result: DVT occurred in 7 patients from the control-group in preoperation, accounted for 18.42%, was shown statistical difference (P<0.05) compared to 0% of the trial-group. 8 patients presented DVT from 31 control patients in postoperation, accounted for 25.81%, also was shown statistical difference (P<0.05) compared to 6.25% of the control group. Platelet count were showed no statistical difference (P>0.05) on admission, pre and postoperation in 2 groups. PT,APTT were showed no statistical difference(P>0.05) on admission, preoperation in 2 groups, and there were showed no statistical difference(P>0.05) between the control-group and trial-group. Hemoglobin content were showed no statistical difference(P>0.05) between on admission and preoperation in 2 group. Postoperative hemoglobin content were decreased in the 2 groups and were statistical difference (P<0.01) compared on admission and preoperative hemoglobin content. Hemoglobin content of postoperative between 2 groups were no statistical difference(P>0.05). Compared control-group(19 cases) in hip replacement patients, an average of bleed loss and postoperative drainage were increased to trial-group(20 cases), were showed no statistical difference(P>0.05), and none bleeding complications. Conclusion: Application of low molecular weight heparin were effective and safe in preventing lower limb deep veins thrombosis (DVT)for elderly patients with hip fracture. The platelet, hemoglobin, clotting mechanisms didn't present obvious change and the amount of blood loss and postoperative drainage also didn't show significant increase between two groups .