摘要
目的:观察中药化栓汤联合低分子肝素对行髋关节置换术老年患者术后凝血相关指标及术后DVT(下肢深静脉血栓形成)的影响。方法:选取我院2011年10月~2014年10月髋关节周围骨折患者92例,依据术后干预方法分为低分子肝素组与中西结合组,每组46例,两组术后均给予低分子肝素治疗,后者加用中药化栓汤内服。观察两组患者凝血相关指标:血小板计数(PLT)、凝血酶原时间(PT)、血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D)等水平变化及用药治疗前后患肢肿胀程度,记录DVT发生率及不良反应发生情况。结果:中西结合组PT、APTT、TT水平较低分子肝素组显著较高(P<0.05);中西结合组髌骨上缘周径较低分子肝素组显著较小(P<0.05)。中西结合组术后下DVT发生率为2.17%较低分子肝素组15.22%显著较低(P<0.05);中西结合组术后不良反应发生率为4.35%较低分子肝素组17.39%显著较低(P<0.05)。结论:中药化栓汤联合低分子肝素防治髋关节周围骨折术后DVT疗效显著,其可能是通过改善血液高凝状态达到抑制血栓形成的,安全可靠,且并未增加不良反应。
Objective: To observe the effect of traditional Chinese medicine( TCM) Huashuan Decoction combined with low molecular weight heparin( LMWH) on coagulation related indexes and postoperative DVT( deep venous thrombosis) for elderly patients undergoing hip replacement. Methods: A total of 92 patients with hip fractures who were admitted to our hospital between October 2011 and October 2014 were divided into LMWH group and combined traditional Chinese and western medicine group,46 cases in each group according to postoperative intervention methods. Both groups were treated with LMWH after the operation,and the latter were additionally treated with TCM Huashuan Decoction. The changes of coagulation related indexes [platelet count( PLT),prothrombin time( PT),plasma fibrinogen( FIB),activated partial thromboplastin time( APTT),thrombin time( TT) ],D-dimer( D-D) level and the degree of limb swelling before and after treatment were observed. The incidence rates of DVT and adverse reactions were recorded. Results: The levels of PT,APTT and TT were significantly higher in the combined traditional Chinese and western medicine group than the LMWH group( P<0. 05). The diameter of the superior margin of the patella was significantly shorter in the combined traditional Chinese and western medicine group than the LMWH group( P<0. 05). The incidence rates of DVT and adverse reactions were lower in the combined traditional Chinese and western medicine group than the LMWH group( 2. 17% and 4. 35% vs 15. 22% and 17. 39%)( P< 0. 05). Conclusion: The effect of TCM Huashuan Decoction combined with LMWH is significant in the treatment of DVT in patients with hip fractures after hip replacement. It can inhibit thrombosis by relieving the hypercoagulable state,safe and reliable,without increasing adverse reactions.
出处
《四川中医》
2017年第9期119-122,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
化栓汤
低分子肝素
髋关节
骨折
下肢深静脉血栓
Huashuan Decoction
Low molecular heparin
Hip joint
Fracture
Deep venous thrombosis of lower extremity
