Two Kinds Of Surgical Treatment Of Intertrochanteric Fractures And Lower Limbs Of Deep Vein Thrombosis Clinical Index Analysis

Purpose and BackgroundIntertrochanteric fractures is common in older population more than ever to be conservative treatment, both at home and abroad, now think that the consensus view surgical treatment is given priority to, the surgical method mainly for fixation (DHS, DCS, GN, PFN) and prosthesis replacement, its postoperative complication of lower extremities important for deep vein thrombosis, deep vein thrombosis,embolus once fall off, embolism in heart, brain, lung organs such as causing serious dysfunction, and even life-threatening pulmonary embolism, especially more difficult to prevent the disease quickly. According to foreign survey statistics, a hip operation postoperative lower extremities caused of deep vein thrombosis more common, especially without thromboembolism prophylaxis in false body replacement cause lower limbs incidence of deep vein thrombosis can reach 30%-60%. In recent years, according to reports in the crowd in Asia after a hip operation lower incidence of deep vein thrombosis with western countries, and basic close attention.Lower limbs of deep vein thrombosis is the consequence of the interaction between multiple factors, currently accepted three main pathogenic factors for:hemal wall damage, blood high pour-point state and slow flow. Due to trauma, surgery can make the deep vein engorgement, vascular intima hypoxia and cause lining damage; Trauma and operation caused by blood and blood high pour-point state; Meanwhile intertrochanteric fracture patients age on the high side, surgical trauma is bigger, postoperative reactive low, bed for a long time, lower limb activity decreases are cause blood slow and deposition, easily induced thrombosis.This experiment aims to blood sugar, blood triglyceride before and after operation, blood cholesterol, platelets and D-such as Dimer clinical index detection, contrast, analyze and discuss, more internal fixation and false body replacement for two operation intertrochanteric fracture lower limbs of deep vein thrombosis influence in the lower extremities, clinical guidance choose deep vein thrombosis influence is relatively minor surgical procedure, as well as the clinical offer lower limbs of deep vein thrombosis early diagnostic basis, and take timely effective treatment and prevention measures.Materials and methods:1.The clinic data This experiment altogether collected in January 2008 to 2010 October cases, including 44 cases of internal fixation of 23 cases and prosthesis replacement 21 cases, age range of 60 to 80 years, mean age 72.2.Methods2.1.The surgery method:Uses dynamic hip screw (DHS), power condyle screws (DCS), Gamma nails (GN), proximal femoral intramedullary nailing (PFN) interior fixation and prosthesis replacement treatment of intertrochanteric fractures.2.2.The experiment methods2.2.1 Blood specimen collection:Acquisition patients morning hollow vein whole blood 8ml, about the whole blood "folic acid sodium are set EDTAK2 anticoagulant tube, anticoagulant pipe and separation hose, preoperative routine examination, including after blood glucose, blood triglycerides, blood cholesterol, platelets and D-Dimer projects. For the first three days after the first seven days with the same methods acquisition morning hollow vein whole blood. All the above actions via patient I agree and execution.2.2.2 Blood specimen detecting:The specimen is sent to our 3000r/15 by mga, centrifugal, take min serum or plasma testing.3.statisticsUsing statistical software SPSS 13.0, analyzes the data between the two groups, blood sugar, blood triglyceride age, blood cholesterol, platelets and D-Dimer using samples for statistical analysis between t test.Result:1. Cases clinical data analysis:By statistical analysis is not think age, sex between the two groups (P>0.05 difference, but cases in women than men.2. Internal fixation with fake body replacement of preoperative blood sugar, blood of blood cholesterol, triglyceride are higher than those of postoperative, and platelet postoperative above preoperative. Two groups of blood sugar, blood triglyceride between blood cholesterol and platelets, still cannot think there are differences between the two groups (P>0.05).3.3. Internal fixation with fake body replacement of preoperative and postoperative 3d and of the D-after Dimer 7d comparative analysis, the two groups of D-Dimer postoperative are higher than the preoperative and postoperative 7d higher than 3d, false body replacement after group D-are slightly higher than Dimer postoperative recovery within fixed groups, but still can't think there are differences between the two groups (P> 0.05).Conclusion:1. Fixation and prosthesis replacement treatment of intertrochanteric fractures of deep vein thrombosis in the lower extremities, there is no difference, clinical effect according to the patient's age and whole body condition, and shift degree and the fracture type choose appropriate surgical method;2. Surgery and blood sugar, blood triglycerides, blood cholesterol and platelet index evaluation of deep vein thrombosis lower no obvious meaning, and postoperative D-Dimer progressive heighten can as lower limbs of deep vein thrombosis monitoring index, comprehensive consideration of the various clinical index to the diagnosis of deep vein thrombosis lower limb of significance.