苦碟子加利伐沙班预防TKA术后下肢深静脉血栓形成及对血液流变学和炎性因子的影响  

Curative Efficacy of Ixeri Sonhifolia Injection in Combination with Rivaroxaban in Preventing Deep Venous Thrombosis of Lower Extremities after Total Knee Arthroplasty and Its Effects on Hemorrheology and Inflammatory Factors

作　　者：白文斌[1] 王凯[1] 韩生寿[1] 许晓伟[1] 

机构地区：[1]青海省人民医院骨科四病区,青海西宁810007

出　　处：《实用骨科杂志》2016年第1期25-27,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨苦碟子注射液联合利伐沙班预防全膝关节置换术(total knee arthroplasty,TKA)后下肢深静脉血栓(deep venous thrombosis,DVT)形成的疗效及对患者血液流变学和炎性因子的影响。方法选取2013年1月至2014年12月于我院接受TKA治疗的术后患者共160例作为研究对象,随机分为对照组(n=80)和观察组(n=80)。常规治疗基础上,对照组给予利伐沙班治疗,观察组在对照组的基础上联合应用苦碟子注射液治疗。治疗后,观察比较两组患者DVT发生率、血液流变学指标、炎性因子水平及不良反应发生情况。结果术后3周内,观察组DVT的发生率为10.0%,明显低于对照组22.5%的DVT发生率,比较差异有统计学意义(P<0.05)。术后1周,与对照组相比,观察组血液流变学指标全血高切黏度、全血低切黏度、血浆黏度、红细胞最大聚集指数、红细胞压积显著下降,炎性因子肿瘤坏死因子α、白细胞介素6、白细胞介素8水平明显降低,比较差异有统计学意义(P<0.05)。治疗过程中,均未出现严重不良反应。观察组和对照组的不良反应发生率分别为8.8%和10.0%,组间比较差异无统计学意义(P>0.05)。结论苦碟子注射液联合利伐沙班能够有效预防TKA术后下肢DVT发生,能够显著改善患者血液流变学指标,减轻机体炎性反应,且不良反应轻微,临床上值得进一步研究。Objective To investigate the clinical effect of ixeri sonhifolia injection in combination with rivaroxaban and its effects on hemorrheology and inflammatory factors in preventing deep venous thrombosis（ DVT） of lower extremities after total knee arthroplasty（ TKA）. Methods 160 cases who underwent TKA admitted by our hospital from January 2013 to December2014 were selected as research objects. Those cases were randomly divided into two groups equally. Besides conventional treatments,he control group was given rivaroxaban,while the observation group was given ixeri sonhifolia injection and rivaroxaban.Then,the incidence of DVT,hemorheology indices,level of inflammatory factors and adverse reactions were observed and compared. Results During the three weeks after the operation,the incidence of DVT in the observation group was 10. 0%,which was statistically lower than that of 22. 5% in the control group（ P〈 0. 05）. One week after the operation,hemorheology indices of whole high blood viscosity,whole low blood viscosity,plasma viscosity,maximum aggression index of erythrocyte,hematocrit and inflammatory factors of TNF-α,IL-6,IL-8 in the observation group was respectively statistically lower than that in the control group（ all P〈 0. 05）. During the treatment,there＇s no case of severe adverse reaction,and the incidence of adverse reactions in the observation group was 8. 8%,which was statistically same with that of 10. 0% in the control group（ P〈 0. 05）.Conclusion Treatment of ixeri sonhifolia injection in combination with rivaroxaban can effectively prevent the incidence of DVT of lower extremities in patients after TKA,and it can significantly improve hemorrheology indices and alleviate inflammatory reaction with minor adverse reactions.

关 键 词：苦碟子注射液 利伐沙班 全膝关节置换术 下肢深静脉血栓 血液流变学 炎性因子 

分 类 号：R687.42[医药卫生—骨科学]