目的:探讨高龄股骨颈骨折患者行人工双极股骨头置换术后围手术期下肢静脉血栓形成的危险因素及在临床防治血栓中脉络舒通丸的作用。方法:收集2015年1月至2020年1月华北理工大学附属医院收治的92例高龄股骨颈骨折患者的临床资料进行回顾性病例对照研究。按治疗方法不同分为观察组44例，对照组48例。观察组应用脉络舒通丸和低分子量肝素钙联合治疗；对照组应用低分子量肝素钙治疗。两组患者均在入院后即开始抗凝治疗，手术前1天停药，术后第2天继续用药。记录入院时、入院后第7天及术后14 d双下肢静脉超声检查情况。记录两组患者手术前后血红蛋白变化量、红细胞计数变化量、术后引流管引流量的差异。结果:观察组入院后第7天血栓发生率为2例(4.54%)，对照组为9例(18.75%)，两组比较差异有统计学意义(χn 2＝4.400，n P＝0.036)；观察组术后14 d血栓发生率为3例(6.82%)，对照组为11例(22.92%)，差异也有统计学意义(χn 2＝4.611，n P＝0.032)。观察组与对照组在术前1 d和术后48 h血红蛋白变化量分别为(23.73±6.89) g/L与(22.10±5.18) g/L；红细胞计数变化量分别为(0.67±0.32)×10n 12/L与(0.56±0.36)×10n 12/L和术后引流管引流量分别为(100.27±23.73) ml与(102.40±20.90) ml；两组患者上述各指标比较差异均无统计学意义(n P均>0.05)。经多因素Logistic回归分析发现仅应用低分子量肝素钙防治血栓(n OR＝10.281，95%n CI：1.609～65.689，n P＝0.014)，患者高龄(n OR＝1.190，95%n CI：1.061～1.336，n P＝0.003)，入院时存在血栓(n OR＝8.346, 95%n CI：1.773～39.281，n P＝0.007)是术后14 d发生下肢静脉血栓的危险因素。n 结论:脉络舒通丸联合低分子量肝素钙可安全、有效地治疗高龄股骨颈骨折人工股骨头置换术围手术期下肢静脉血栓。脉络舒通丸联合低分子量肝素钙是术后14 d下肢静脉血栓形成的保护性因素，而高龄、入院时存在血栓是危险因素。“,”Objective:To investigate the risk factors of lower extremity venous thrombosis in elderly patients with femoral neck fracture during perioperative period after artificial bipolar femoral head replacement and the effect of Mailuoshutong in clinical prevention and treatment of thrombosis.Methods:A retrospective case-control study was conducted on the clinical data of 92 elderly patients with femoral neck fracture who were admitted to the Affiliated Hospital of North China University of Technology from January 2015 to January 2020.According to the treatment method, the patients were divided into an observation group (44 cases) and a control group (48 cases). Patients in the observation group were treated with the combination of Mailuoshutong Pill and low molecular weight heparin calcium.The control group was treated with low molecular weight heparin calcium.The patients in both groups started anti-coagulation therapy immediately after admission, and they stopped the drug one day before operation and continued to take the drug on the second day after operation.Venous ultrasound of both lower limbs was recorded at the time of admission, on the 7th day after admission, and 14 days after surgery.The changes in hemoglobin, red blood cell count and drainage volume before and after operation were recorded.Results:The incidence of thrombosis was 2 cases (4.54%) on the 7th day after admission in the observation group and 9 cases (18.75%) in the control group.The difference was statistically significant (χn 2=4.400, n P=0.036). The incidence of thrombosis was 3 cases (6.82%) in the observation group and 11 cases (22.92%) in the control group 14 days after operation.The difference was statistically significant(χn 2=4.611, n P=0.032). The hemoglobin changes of observation group and control group were (23.73±6.89) g/L and (22.10±5.18) g/L respectively on the first day before operation and 48 hours after operation.The red blood cell count changes were (0.67±0.32) × 1012/L and (0.56±0.36) × 1012/L respectively, and the drainage volume of drainage tube after operation was (100.27±23.73) ml and (102.40±20.90) ml, respectively.There was no significant difference in the above indexes between the two groups (all n P>0.05). Multivariate Logistic regression analysis showed that only low molecular weight heparin calcium was used to prevent and treat thrombosis (n OR=10.281, 95% CI: 1.609-65.689, n P=0.014); the elderly patients (n OR=1.190, 95% CI: 1.061-1.336, n P=0.003) and the thrombosis at the time of admission (n OR=8.346, 95% CI: 1.773-39.281, n P=0.007) were the risk factors for lower extremity venous thrombosis on the 14th day after surgery.n Conclusion:Mailuoshutong pill combined with low molecular weight heparin calcium can safely and effectively treat lower extremity venous thrombosis in perioperative period of artificial femoral head replacement for femoral neck fracture in elderly patients.Mailuoshutong pill combined with low molecular weight heparin calcium was a protective factor for lower extremity venous thrombosis 14 d after operation, while advanced age and thrombosis at the time of admission were risk factors.