摘要
目的:探讨低分子肝素(LMWH)对脊柱创伤患者CS椎弓根螺钉术后血流变学、炎症细胞因子及凝血功能的影响。方法:选取我院收治的脊柱创伤患者80例,随机分为治疗组及对照组,各40例,两组均行PCS椎弓根螺钉固定术治疗,治疗组在术后给予LMWH皮下注射治疗;对比两组手术前后血流变学指标、炎症细胞因子水平及凝血功能变化。结果:两组术前的RBV低切、中切、高切(mPa·s)及血小板聚集率(PAR)、PAR(1min)(%)比较无统计学差异(P>0.05),术后24h上述指标均较术前明显上升(P<0.05);治疗组术后24h上述指标均明显低于对照组(P<0.05);对照组术后48h及术后1周上述各项指标较术前持续升高,治疗组较术前持续下降(P<0.05);治疗组术后C-反应蛋白(CRP)及白细胞介素6、10(IL-6、IL-10)水平均明显低于同期对照组(P<0.05);治疗组术后血浆凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)及纤维蛋白原(FIB)均明显低于对照组(P<0.05)。结论:LMWH能够有效降低脊柱创伤PCS椎弓根螺钉术后患者血液黏度,抑制炎症反应,利于患者术后康复。
Objective： To explore the effect of low molecular weight heparin （LMWH） on the hemorheology, inflamma- tory cytokines, and coagulation funtion in patients with spinal trauma after PCS pedicle screw fixation. Methods： A total of 80 patients with spinal trauma who were admitted in our hospital were included in the study and randomized into the treatment group and the control group with 40 cases in each group. The patients in the two groups were performed with PCS pedicle screw fixation. The patients in the treatment group were given subcutaneous injection of LMWH after operation. The hemorhe- ology indicators, inflammatory cytokines levels, and coagulation function change before and after operation in the two groups were compared. Results= The comparison of RBV （low shear, middle shear, and high shear） （mPa ~ s）, PAR, and PAR （1 min） （%） before operation between the two groups was not statistically significant （P〉0.05）, the above indicators 24 h after operation in the two groups were significantly elevated when compared with before operation （P〈0.05）, and the above indica- tors 24 h after operation in the treatment group were significantly lower than those in the control group （P〈0.05）. The above indicators 48 h and 1 week after operation in the control group were significantly elevated, while those in the treatment group were significantly reduced when compared with before treatment （P 〈0.05）. CRP, IL-6, and IL-10 levels after operation in the treatment group were significantly lower than those in the control group （P〈0.05）. PT, APTT, and FIB after operation in the treatment group were significantly lower than those in the control group （P〈0.05）. Conclusions： LMWH can effectively re- duce the blood viscosity, inhibit the inflammatory reaction, and contribute to postoperative rehabilitation in patients with spinal trauma after PCS pedicle screw fixation.
出处
《海南医学院学报》
CAS
2016年第22期2739-2741,共3页
Journal of Hainan Medical University
基金
四川省南充市科技局科学技术计划项目(15A0039)~~
