To Investigate The Clinical Early Diagonosis Value And Effect Of Low Molecular Heparins To Cure Deep Venous Thrombosis In Elderly Lower Limbs Fracture Patients.

Objective:To study the clinical action of Fib,D-dimer,P-selectin, coagulation factor X(FXa)and anti activated factor X avtivity(AXa)et al in olderly lower limb fracture with low-molecular weight heparin(LMWH)nonsurgical treatment and prevent deep venous thrombosis(DVT).Methods:The level of Fib, D-dimer and P-selectin et al was detected.And those indexs were analyzed by receiver operating characteristic curve(ROC curve).The effective rate of LMWH to DVT and the rate of the side-reaction were observed.In the same time,Concentration and activity of FXa,AXa,APTT time et al were detected and observed.Indexes was analyzed according instruction operate.Results:Frist,The levels of PT,APTT, plasma viscosity had no significantly difference in control group,DVT group and no DVT group,others had significantly difference(P＜0.05).There were significantly difference of Fib,D-dimer and P-selectin between DVT group and no DVT group(P＜0.05),others had no meanings of statistics(P＞0.05).Fib,D-dimer and P-selectin of areas of ROC were more 0.5.Second,The incidence of DVT in no treatment group was 56.67%,treatment group was 3.33%,And there were significantly difference(P＜0.05).Concentration and activity of FXa of treatment group was significantly difference(P＜0.05)than no treatment group in before therapy and after therapy.APTT time of treatment group has a little prolong in after 14 day,But no statistics significance.Third,The effective rate of LMWH to DVT of treatment group 1 and treatment group 2 were 62.5%and 92.5%,and there were significant difference between two groups(P＜0.05).The rate of the side-reaction of LMWH to DVT of treatment group 1 and treatment group 2 were 7.5%and 10%,and there were no significant difference between two groups(P＞0.05).In the treatment group 2,the concentration of Fib,D-dimer in treatment two weeks were significantly difference(P＜0.05)than that in treatment one week.But APTT and AXa was no significantly difference(P＞0.05),treatment two weeks was higher than treatment one week.conclusion:Early to test the level of Fib,D-dimer and P-selectin of fracture patients have the value of exclude in post-fracture DVT.FXa was inspect index of LMWH prevent after olderly lower limb fracture DVT.Use routine dose LMWH to cure DVT in elderly lower limbs trauma is efficacy and safety,and no need to detect the index of.lab.But this study suggest that APTT should be measured as a routine parameter monitoring LMWH in Lab when concentration of AXa is equal or more than 1.0U/ml,especially subjects with the obese or thin or severe renal failure,need treatment for a long time,to obtain better therapentic effect and safe thereby.