低分子肝素钠注射液治疗膝关节置换术后静脉血栓预后的临床研究  

Clinical trial of low molecular weight heparin sodium injection for the prognosis after knee replacement surgery

作　　者：王昕[1] 完颜萍萍 胡龙[1] 陶贵彦[1] 王文己[1] 

机构地区：[1]兰州大学第一医院/兰州大学第一临床医学院骨科,兰州730000 [2]兰州大学第二医院血液净化中心,兰州730000

出　　处：《中国临床药理学杂志》2016年第21期1957-1959,共3页The Chinese Journal of Clinical Pharmacology

基　　金：甘肃省科学计划基金资助项目(1107RJZA256)

摘　　要：目的观察低分子肝素钠对膝关节置换术后静脉血栓预后的临床疗效。方法将93例进行膝关节置换手术患者随机分为对照组46例和试验组47例。对照组术后予以皮下注射肝素钠注射液1.25×104U qd;试验组术后予以皮下注射低分子肝素钠2500 U qd。2组患者均治疗7 d。比较2组患者的红细胞沉降率(ESR)、白细胞介素-6(IL-6)、D-二聚体(D-D)、血小板相关指标、静脉血栓和药物不良反应的发生情况。结果治疗后,试验组和对照组的ESR分别为(18.95±2.46),(25.08±3.03)mm·h-1;IL-6分别为(14.23±2.11),(26.08±3.16)pg·m L^(-1);D-D分别为(2.83±0.33),(5.93±0.71)mg·L^(-1);血小板计数分别为(137.29±14.29)×109,(149.29±15.29)×109/L;血小板体积分别为(12.98±1.34),(12.02±1.32)f L;血小板分布宽度分别为(12.98±1.34),(13.99±1.49)f L;大血小板分布比率分别为(45.00±6.28)%,(37.98±4.35)%,差异均有统计学意义(P<0.05)。试验组和对照组的静脉血栓发生率分别为2.13%和21.74%,差异有统计学意义(P<0.05)。2组患者的药物不良反应以注射部位疼痛和胃肠道反应为主,且试验组和对照组的药物不良反应发生率分别为6.38%和8.70%,差异无统计学意义(P>0.05)。结论低分子肝素钠对膝关节置换术后静脉血栓预后的临床疗效显著,且不增加药物不良反应发生率。Objective To observe the clinical efficacy and safety of low molecular weight heparin sodium for the prognosis after knee replacement surgery. Methods Ninety -three patients with knee replacement sur- gery were randomly divided into control group （ n = 46 ） and treatment group（n =47）. Control group was given heparin sodium injection 1.25 × 104 U, subcutaneous injection, qd. Treatment group was given low molecular weight heparin sodium injection 2500 U, subcutaneous injec- tion, qd. Two groups were treated for 7 d. The erythrocyte sedimentation rate （ ESR）, interleukin - 6 （ IL - 6 ）, D - dinner （ D - D ）, platelet rela- ted parameters, incidence of venous thrombosis and adverse drug reac- tions were compared in two groups. Results After treatment, the main indexes in treatment and control groups were compared： ESR were （18.95 ± 2.46）, （25.08 ± 3.03） mm h-1; IL - 6 were （14.23±2.11）, （26.08 ± 3.16） pg mL-1; D - D were （2.83 ±0. 33）, （5.93 ±0. 71 ） mg L-1 ; platelet counts were（ 137. 29 ± 14. 29） x 109, （ 149.29 ± 15.29） × 109/L; mean platelet volume were （ 12. 98 ± 1.34 ）, （ 12. 02 ±1.32 ） fL; platelet distribution width were （ 12.98 ± 1.34 ）, （ 13.99± 1.49） fL; large platelet distribution ratio were （45.00 ± 6. 28 ） %, （ 37.98 ± 4. 35 ） %, the differences were statistically significant （P 〈 0. 05 ）. The adverse drug reactions were based on injection site pain and gastrointestinal reactions. The incidence of adverse drug reactions had no significant difference in treatment and control groups（6. 38% vs 8. 70%, P 〉0. 05）. Conclusion Low molecular weight heparin sodium has a definitive clinical efficacy for the posto- perative venous thrombosis after knee replacement surgery,without increasing the incidence of adverse drug reactions.

关 键 词：低分子肝素钠 膝关节置换术 静脉血栓 安全性 

分 类 号：R973.2[医药卫生—药品]