探讨低分子肝素钙结合物理疗法对预防髋关节置换术后下肢深静脉血栓(DVT)形成的效果及对患者凝血功能、生活质量评分及空腹血糖水平的影响。

将钦州市第一人民医院2019年9月至2022年3月期间行髋关节置换术的60例股骨颈骨折患者，应用随机数字表法分成对照组和观察组，每组30例。术后8 h，对照组患者采取物理疗法，观察组为物理疗法及低分子肝素钙注射，均治疗2周。卡方检验比较两组患者治疗期间下肢深静脉血栓发生情况，t检验比较两组患者治疗前后凝血功能指标变化，治疗后生活质量评分及治疗期间空腹血糖水平的影响。

治疗期间，观察组患者DVT发生率低于对照组(χ²＝4.706，P<0.05)；治疗后两组患者纤维蛋白原(FIB)、D-二聚体(D-Dimmer)较治疗前下降；凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)值较治疗前升高(对照组：t＝3.065、8.765、3.751、9.419，均为P<0.05；观察组：t＝9.961、35.437、2.084、3.080，均为P<0.05)；两组之间相比较，FIB、D-Dimmer、PT、APTT等治疗前两组患者之间差异无统计学意义(t＝0.562、1.607、0.954、0.213，均为P>0.05)，治疗后观察组的FIB、D-Dimmer、PT、APTT等指标低于对照组(t＝7.364、18.819、2.100、7.418，均为P<0.05)；治疗后观察组躯体功能、心理功能、物质生活状态、社会功能评分优于对照组(t＝14.342、12.209、18.425、18.179，均为P<0.05)；治疗前和治疗后两组患者间的空腹血糖水平差异无统计学意义(t＝0.276、0.228、0.249，均为P>0.05)。

低分子肝素钙联合物理疗法可有效降低髋关节置换术后DVT的发生率，并可有效改善患者的血液高凝状态，提高生活质量，且治疗期间对患者的空腹血糖水平无影响，值得临床推广应用。

To evaluate the effectiveness of low-molecular-weight heparin combined with physical therapy in preventing the deep venous thrombosis (DVT) of the lower extremities after hip replacement, as well as the influences for the coagulation function, life quality score and fasting blood-glucose of the patients.

A total of 60 femoral neck fracture patients, who were admitted hip replacement from September 2019 to March 2022 in Qinzhou First People’s Hospital, were divided into the observation group and the control group by random number table method. The observation group received physical therapy combined with low molecular heparin calcium administration, while the control group received only physical therapy for two weeks. Chi-square test was applied to compare the occurrence of DVT between the two groups of patients during treatment, and t test was applied to compare the change of coagulation function indicators, quality of life score after treatment and the impact of fasting blood glucose level during treatment between the two groups of patients.

The incidence of venous thrombosis in observation group was lower than that in the control group (χ²=4.706, P<0.05). After the treatment, fibrinogen(FIB) and D-Dimmer values decreased, and the prothrombin time(PT)and activated partial thromboplastin time(APTT)values increased obviously in both groups (the control group : t=3.065, 8.765, 3.751, 9.419, all P<0.05; the observation group: t=9.961, 35.437, 2.084, 3.080, all P<0.05). The comparison between the two groups suggested that no statistically significant difference before the treatment (t=0.562, 1.607, 0.954, 0.213, all P>0.05). FIB, D-Dimmer, PT and APTT of the observation group were lower than those of the control group after treatment ( t=7.364, 18.819, 2.100, 7.418, all P<0.05). The scores of physical function, psychological function, material life status and social function in the observation group were better than that of control group after the treatment( t=14.342, 12.209, 18.425, 18.179, all P<0.05). There was no statistically significant difference in fasting blood glucose levels between the two groups before and after the treatment. (t=0.276, 0.228, 0.249, all P>0.05).

Low molecular weight heparin calcium combined with physical therapy could effectively reduce the incidence of DVT after hip replacement, ameliorate the hypercoagulable state and improve the quality of life, no obvious influence in patient′s fasting blood glucose level during treatment, which implies the clinical value of this therapy.