中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (12): 2957-2964.doi: 10.12307/2026.718

• 骨组织构建 bone tissue construction • 上一篇    下一篇

高剂量低分子量肝素对股骨干骨折愈合的影响

石腾博1，2，倘艳锋1，2，张孟瑜3，王幸飞1，2，李晨阳2，4，师锦玉1，2，郭超韡2，李彦州2，贺自克1，5，王上增1，5   

  1. 1河南中医药大学骨伤学院，河南省郑州市  450000；2河南省洛阳正骨医院(河南省骨科医院)髋部损伤中心，河南省洛阳市  471002；3南京中医药大学第一临床医学院，江苏省南京市  210029；4福建中医药大学，福建省福州市  350122；5河南省中医院关节科，河南省郑州市  450002
  • 收稿日期:2025-05-15 接受日期:2025-08-15 出版日期:2026-04-28 发布日期:2025-09-28
  • 通讯作者: 倘艳锋，副教授，硕士生导师，河南中医药大学骨伤学院，河南省郑州市 450000；河南省洛阳正骨医院(河南省骨科医院)髋部损伤中心，河南省洛阳市 471002 共同通讯作者：贺自克，副教授，硕士生导师，河南中医药大学骨伤学院，河南省郑州市 450000；河南省中医院关节科，河南省郑州市 450002
  • 作者简介:石腾博，男，1998年生，河南省周口市人，汉族，河南中医药大学在读硕士，主要从事中医药防治创伤与骨不愈合研究。 共同第一作者：张孟瑜，女，1998年生，河南省洛阳市人，汉族，南京中医药大学在读硕士，主要从事中医妇科及生殖内分泌疾病的研究。
  • 基金资助:
    河南省医学科技攻关计划联合共建项目(LHGJ20220251)，项目负责人：倘艳锋；河南省中医药拔尖人才培养项目专项课题(2022ZYBJ22)，项目负责人：倘艳锋

Effect of high-dose low molecular weight heparin on the healing of femoral shaft fractures 

Shi Tengbo1, 2, Tang Yanfeng1, 2, Zhang Mengyu3, Wang Xingfei1, 2, Li Chenyang2, 4, Shi Jinyu1, 2, Guo Chaowei2, Li Yanzhou2, He Zike1, 5, #br# Wang Shangzeng1, 5#br#   

  1. 1School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; 2Hip Injury Center of Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang 471002, Henan Province, China; 3The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China; 4Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China; 5Joint Department of Henan Province Hospital of TCM, Zhengzhou 450002, Henan Province, China
  • Received:2025-05-15 Accepted:2025-08-15 Online:2026-04-28 Published:2025-09-28
  • Contact: Tang Yanfeng, Associate professor, Master's supervisor, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Hip Injury Center of Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang 471002, Henan Province, China Co-corresponding author: He Zike, Associate professor, Master's supervisor, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Joint Department of Henan Province Hospital of TCM, Zhengzhou 450002, Henan Province, China
  • About author:Shi Tengbo, MS candidate, School of Bone and Injury of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China; Hip Injury Center of Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang 471002, Henan Province, China Zhang Mengyu, MS candidate, The First School of Clinical Medicine of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China Shi Tengbo and Zhang Mengyu contributed equally to this work.
  • Supported by:
    Joint Construction Project of Henan Medical Science and Technology Research and Development Program, No. LHGJ20220251 (to TYF); Special Project on Training Top Talents in Traditional Chinese Medicine in Henan Province, No. 2022ZYBJ22 (to TYF)

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摘要：


文题释义：
低分子量肝素：是一种通过化学或酶解反应从普通肝素中提取的抗凝药物，广泛用于预防和治疗深静脉血栓。
股骨干骨折：是指股骨干部位因高能量创伤导致的骨皮质连续性中断，常伴随深静脉血栓风险。

背景：股骨干骨折患者常伴随深静脉血栓风险，低分子量肝素是预防深静脉血栓的常用药物。然而，低分子量肝素对骨折愈合的影响尚存争议，部分研究表明其可能抑制成骨细胞分化，延缓骨折愈合。
目的：探讨高剂量低分子量肝素对股骨干骨折愈合的影响。
方法：分析2023年1-12月期间100例股骨干骨折患者的资料，男51例，女49例，年龄(56.26±15.46)岁，根据入院后12 h内双下肢彩超筛查深静脉血栓存在情况分为无血栓组和血栓形成组，每组50例。无血栓组应用低分子量肝素腹部皮下注射预防血栓，每次100 U/kg，1次/d，连续应用2周；血栓形成组应用低分子量肝素腹部皮下注射抗凝治疗血栓，每次100 U/kg，1次/12 h，连续应用2周。记录两组患者的患肢肿胀评分、RUST骨折愈合评分、骨折愈合时间和HSS肢体功能评分。
结果与结论：共93例患者完成随访，其中血栓形成组48例，无血栓组45例。两组患者术前一般资料比较差异均无显著性意义(P > 0.05)。血栓形成组在术后3 d、术后1周的肢体肿胀评分均显著高于无血栓组(P < 0.05)；血栓形成组的骨折愈合时间显著长于无血栓组(P < 0.05)；血栓形成组术后3个月的RUST骨折愈合评分和HSS肢体功能评分均显著低于无血栓组(P < 0.05)，术后6，9个月时两组患者RUST骨折愈合评分和HSS肢体功能评分无显著差异(P > 0.05)。结果表明，高剂量低分子量肝素应用早期可延迟骨折愈合时间，增加潜在出血风险，但对于股骨干骨折最终愈合无明显影响。
https://orcid.org/0009-0008-8240-4872(石腾博)

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 低分子量肝素, 股骨干骨折, 深静脉血栓, 骨折愈合, 炎症, 抗凝, 肢体肿胀, 成骨细胞

Abstract: BACKGROUND: Patients with femoral shaft fractures often have a risk of deep vein thrombosis, and low molecular weight heparin is a commonly used medication for preventing deep vein thrombosis. However, the effect of low molecular weight heparin on fracture healing remains controversial, with some studies suggesting that it may inhibit osteoblast differentiation and delay fracture healing.
OBJECTIVE: To investigate the effect of high-dose low molecular weight heparin on the healing of femoral shaft fractures.
METHODS: The data of 100 patients with femoral shaft fractures from January 2023 to December 2023 were analyzed, including 51 males and 49 females, aged (56.26±15.46) years. According to the presence of deep vein thrombosis detected by bilateral lower limb ultrasound screening within 12 hours after admission, they were divided into a non-thrombosis group and a thrombosis group, with 50 cases in each group. The non-thrombotic group received subcutaneous injection of low molecular weight heparin into the abdomen to prevent thrombosis, at a dose of 100 U/kg, once a day, for 2 consecutive weeks. The thrombosis group was treated with subcutaneous injection of low molecular weight heparin into the abdomen for anticoagulation therapy of thrombosis, at a dose of 100 U/kg, every 12 hours, for 2 consecutive weeks. The swelling score of the affected limb, radiographic union score for tibia, fracture healing time, and Hospital for Special Surgery limb function score in both groups were recorded.
RESULTS AND CONCLUSION: A total of 93 patients completed follow-up, including 48 cases in the thrombosis group and 45 cases in the non-thrombosis group. There was no significant difference in preoperative general information between the two groups of patients (P > 0.05). The limb swelling scores of the thrombosis group were significantly higher than those of the non-thrombosis group at 3 days and 1 week after surgery (P < 0.05). The fracture healing time of the thrombosis group was significantly longer than that of the non-thrombosis group (P < 0.05). The radiographic union score for tibia and Hospital for Special Surgery limb function score in the thrombosis group were significantly lower than those in the non-thrombosis group at 3 months after surgery (P < 0.05). There was no significant difference in radiographic union score for tibia and Hospital for Special Surgery limb function score between the two groups of patients at 6 and 9 months after surgery (P > 0.05). These results indicate that early application of high-dose low molecular weight heparin can delay fracture healing and increase potential bleeding risk, but has no significant effect on the final healing rate of femoral shaft fractures.

Key words: low molecular weight heparin, femoral shaft fracture, deep vein thrombosis, fracture healing, inflammation, anticoagulation, limb swelling, osteoblasts

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