Therapeutic Effect Of Two Anticoagulants On Elderly Patients With Hip Fracture During Perioperative Period

ObjectiveTo compare the efficacy of low molecular weight heparin sodium and low molecular weight heparin calcium in preventing DVT in elderly patients with hip fracture during perioperative period,and to provide reference for the selection of anticoagulant drugs in elderly patients with hip fracture after operation.MethodsAccording to the inclusion criteria and exclusion criteria,152 elderly patients with hip fracture(including femoral neck fracture and femoral intertrochanteric fracture)admitted to our hospital from March 2012 to November 2017 were screened.The age ranged from 60 to 85 years and the weight ranged from 50 kg to 70 kg.Among them,68 cases were treated with low molecular weight heparin sodium(group A)and 84 cases were treated with low molecular weight heparin calcium(group B).Low molecular weight heparin sodium was produced by Alfa Westman Pharmaceutical Company of Italy,and low molecular weight heparin calcium was produced by Zhaoke Pharmaceutical Company(Hefei)Ltd.According to the Guidelines for Prevention of Deep Venous Thromboembolism in Chinese Orthopaedic Surgery 2016,patients who have undergone surgery within 12 hours after injury can receive routine doses of low molecular weight heparin 12 hours after operation.Those who have delayed surgery will begin to use routine doses of low molecular weight heparin from the date of admission and stop using it 12 hours before operation.According to the supplementary instructions of the Guidelines,the medication should refer to the drug instructions used.The patients in group A were given a routine dose of 4250 IU of low molecular weight heparin sodium subcutaneously,once a day.The patients in group B were given a routine dose of 2500 IU of low molecular weight heparin calcium subcutaneously,once a day.The two groups were given medicine for at least 10 days after operation.The incidence of deep venous thrombosis of lower limbs,subcutaneous hemorrhage,hemoglobin and postoperative drainage of the two groups were statistically analyzed.The difference between the two groups was statistically significant(P < 0.05).Result1: The incidence of DVT in the two groups was tested by paired X_test,P > 0.05,which showed that there was no significant difference between low molecular weight heparin sodium and low molecular weight heparin calcium in preventing the occurrence of DVT in perioperative period.2: The hemoglobin data of two groups were analyzed by variance analysis of repeated measurements.There was no significant difference in the hemoglobin levels of the same group at different times,and there was no significant difference in the hemoglobin levels of the two groups during the perioperative period.3: Single-factor analysis of variance of drainage volume after operation in the two groups,P > 0.05,showed that there was no significant difference in the effect of low molecular weight heparinsodium and low molecular weight heparin calcium on drainage volume after operation.4: The number of cases of abdominal subcutaneous hemorrhage in the two groups was analyzed by one-way ANOVA(P < 0.05).It showed that there were significant differences between low molecular weight heparin calcium and low molecular weight heparin sodium in causing subcutaneous hemorrhage.5.The coagulation function of the two groups was analyzed by variance analysis at admission and 3 days after operation,P < 0.05,indicating that PT,APTT and low molecular weight heparin calcium were prolonged at 3 days after operation.Conclusion1.Low molecular weight heparin sodium has the same effect as low molecular weight heparin calcium in preventing DVT in perioperative period of hip fracture in the elderly;2.Low molecular weight heparin sodium is more likely to cause subcutaneous hemorrhage than low molecular weight heparin calcium.