低分子量肝素联合疏血通治疗下肢骨折后深静脉血栓  

Low-molecular-weight heparin plus Shuxuetong for deep venous thrombosis following lower extremity fracture

作　　者：赵磊[1] 吴春生[2] 张英泽[2] 李志杰[2] 宋朝晖[2] 宋连新[2] 彭阿钦[2] 

机构地区：[1]河北医科大学第四医院骨科 河北医科大学第三医院创伤急救中心,石家庄050019 [2]河北医科大学第三医院创伤急救中心

出　　处：《中华创伤杂志》2015年第1期50-53,共4页Chinese Journal of Trauma

摘　　要：目的 比较低分子量肝素与低分子量肝素联合疏血通对下肢骨折后深静脉血栓（DVT）的治疗效果. 方法 选择2010年12月-2012年11月下肢骨折患者1 037例,出现DVT患者79例,DVT发生率7.6％,纳入研究42例,男31例,女11例;平均年龄63岁（26～ 82岁）.按随机数字表法分为低分子肝素组（A组,19例）和联合组（B组,23例）治疗.A组使用低分子肝素钠4 250 IU皮下注射,2次/d;B组使用低分子肝素钠4 250 IU皮下注射,2次/d,同时联合疏血通6 ml加入9g/L氯化钠注射液250 ml中静脉滴注,1次/d.每周为1个疗程,复查双下肢深静脉彩超. 结果 42例患者最长治疗时间为3周.A组中再通2例,平均时间2.50周;显效3例,平均时间2.67周;有效7例,平均时间3周;无明显变化或加重7例,平均时间3周.B组中再通7例,平均时间1.86周;显效12例,平均时间1.83周;有效3例,平均时间3周;无明显变化或加重1例,平均时间3周.两组差异有统计学意义（P＜0.05）. 结论 低分子量肝素联合疏血通治疗下肢骨折后DVT疗效明确,可以作为临床治疗骨折后DVT的选择之一.Objective To compare the therapeutic results between low-molecular-weight heparin therapy and combined therapy of low-molecular-weight heparin and Shuxuetong for deep venous thrombosis （DVT） after lower extremity fracture.Methods Forty-two patients with DVT from 1,037 patients with lower extremity fracture treated from December 2010 through November 2012 were included in the study.There were 31 males and 11 females,aged from 26 to 82 years （mean,63 years）.The patients were assigned to administration of 4,250 IU low-molecular-weight heparin subcutaneously,twice daily （Group A,n =19）and 4,250 IU low-molecular-weight heparin subcutaneously,twice daily plus shuxuetong to 6 ml intravenously,once daily （Group B,n =23） according to the random number table.A period of treatment was a week.Color Doppler sonography was performed to detect DVT.Results Longest course of treatment was 3 weeks.In Group A,the results were recanalization in 2 patients with mean time of 2.50 weeks,significantly effective in 3 patients with mean time of 2.67 weeks,effective in 7 patients with mean time of 3 weeks,and invalid or worse in 7 patients with mean time of 3 weeks.Whereas in Group B,the results were recanalization in 7 patients with mean time of 1.86 weeks,significantly effective in 12 patients with mean time of 1.83 weeks,effective in 3 patients with mean time of 3 weeks,and invalid or worse in 1 patient with mean time of 3 weeks （P 〈 0.05）.Conclusion Low-molecular-weight heparin plus Shuxuetong is effective in treatment of DVT after lower extremity fracture and hence can be as an option in clinical application.

关 键 词：静脉血栓形成 骨折 下肢 肝素 低分子量 疏血通 

分 类 号：R683.42[医药卫生—骨科学]