摘要
目的 观察磺达肝癸钠、依诺肝素钠在下肢慢性骨髓炎行组织瓣移植术后的临床疗效。方法 选择2020年6月至2022年6月于四川现代医院治疗的下肢慢性骨髓炎行组织瓣移植术患者共48例,随机分为磺达肝癸钠组、依诺肝素钠组,两组各24例。在术后抗感染、抗血管痉挛等治疗的基础上,分别给予皮下注射磺达肝癸钠、依诺肝素钠,观察两组患者组织瓣坏死率、血管危象发生率、下肢深静脉血栓及肺栓塞形成率、出血事件发生率、血红蛋白、血小板计数等。结果 磺达肝癸钠组0例坏死,0例发生血管危象,依诺肝素钠组1例坏死,3例发生血管危象;两组组织瓣坏死率及血管危象发生率比较,差异无统计学意义(P>0.05)。磺达肝癸钠组0例发生肺栓塞,1例发生下肢深静脉血栓;依诺肝素钠组0例发生肺栓塞,3例发生下肢深静脉血栓,两组患者肺栓塞及下肢深静脉血栓发生率比较,差异无统计学意义(P>0.05)。磺达肝癸钠组有1例发生明显出血倾向,1例发生注射部位皮下瘀斑,1例牙龈出血;依诺肝素钠组有0例发生明显出血倾向,4例发生注射部位皮下瘀斑,两组出血事件发生率比较,差异无统计学意义(P>0.05)。两组患者在住院期间最后一次血红蛋白、血小板计数比较,差异无统计学意义(P>0.05)。结论 在慢性骨髓炎行组织瓣移植术后磺达肝癸钠与依诺肝素钠疗效与安全性相当。
Objective To observe the clinical efficacy of fondaparinux sodium and enoxaparin sodium on patients with chronic osteomyelitis of lower limbs after tissue flap transplantation.Methods A total of 48 patients with chronic osteomyelitis of lower limbs who received tissue flap transplantation in Sichuan Modern Hospital from June 2020 to June 2022 were selected and randomly divided into two groups:fondaparinux sodium group and enoxaparin sodium group,with 24 cases in each group.On the basis of treatment such as anti-infection and anti-vasospasm after surgery,the necrosis rate of tissue flap,the incidence of vascular crisis,the formation rate of deep vein thrombosis(DVT)and pulmonary embolism(PE),and the incidence of bleeding events were observed in the two groups.Results There were 0 cases of necrosis and 0 cases of vascular crisis in fondaparinux sodium group,there were 1 cases of necrosis and 3 cases of vascular crisis in enoxaparin group,with no statistical significance in the rate of flap necrosis and incidence of vascular crisis between the two groups(P>0.05).In fondaparinux sodium group,0 case had PE and 1 case had DVT of lower extremity,in enoxaparin sodium group,there were 0 cases of PE and 3 cases of lower extremity DVT,there was no significant difference in the incidence of PE and DVT between the two groups(P>0.05).There was obvious bleeding tendency in 1 case,subcutaneous ecchymosis at the injection site in 1 case and gingival bleeding in 1 case in the fondaparinux sodium group,in the enoxaparin sodium group,0 cases had obvious bleeding tendency,and 4 cases had subcutaneous ecchymosis at the injection site,there was no statistical significance in the incidence of bleeding events between the two groups(P>0.05).There was no statistically significant difference in the last hemoglobin and platelet count between the two groups of patients during hospitalization(P>0.05).Conclusion The efficacy and safety of fondaparinux sodium and enoxaparin sodium in patients with chronic osteomyelitis after tissue flap transplantation are comparable.
作者
郑华
刘亚平
崔太安
赵徐英
ZHENG Hua;LIU Yaping;CUI Tai'an;ZHAO Xuying(Sichuan Modern Hospital,Chengdu Sichuan 610041,China)
出处
《药品评价》
CAS
2023年第7期858-862,共5页
Drug Evaluation
基金
四川省医学会静脉血栓栓塞症防治(恒瑞)专项科研课题(2019HR54)。
关键词
骨髓炎
穿支皮瓣
磺达肝癸钠
依诺肝素钠
静脉血栓栓塞症
Osteomyelitis
Perforator flap
Fondaparinux sodium
Enoxaparin sodium
Venous thromboembolism
