活血通络膏联合低分子肝素钙预防全髋关节置换术后深静脉血栓形成的临床观察  

Clinical Study of Application of Huoxue Tongluo Ointment Combing Low-molecular-weight Heparin Calcium Injection in Preventing Deep Venous Thrombosis after Total Hip Arthroplasty

作　　者：李文龙[1] 李阳阳[1] 张海龙[1] 王会超[2] 刘又文[2] 

机构地区：[1]河南中医药大学,河南郑州450008 [2]河南省洛阳正骨医院河南省骨科医院,河南洛阳471002

出　　处：《中国中医急症》2017年第2期339-342,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：2015年度河南省中医药科学研究专项课题(2015ZY02069)

摘　　要：目的观察活血通络膏联合低分子肝素钙预防全髋关节置换术(THA)术后患者下肢深静脉血栓形成的临床疗效。方法将69例接受单侧THA手术的患者随机分为试验组33例与对照组36例。对照组给予低分子肝素钙10 d,试验组在对照组基础上加用活血通络膏14 d。在术前、术后7、14 d分别检测患肢深静脉彩超,测定活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、血浆D-二聚体(D-D)及血小板计数(PLT);术前1 d、术后1、7、14 d分别测量患肢大腿及小腿周径。结果试验组APTT、PT与术前比较,术后7 d均明显延长;与本组术后7 d比较,术后14 d亦明显延长,差异具有统计学意义(P<0.05);与对照组同时间段比较,差异均具有统计学意义(均P<0.05)。试验组D-D与术前比较,术后7 d明显升高;与本组术后7 d比较,术后14 d明显下降,差异具有统计学意义(P<0.05);与对照组同时间段比较,术后7 d差异无统计学意义(P>0.05),术后14 d差异具有统计学意义(P<0.05)。试验组PLT与术前比较,术后7 d明显升高;与本组术后7 d比较,术后14 d亦明显升高,差异具有统计学意义(P<0.05);与对照组同时间段比较,差异无统计学意义(均P>0.05)。试验组大腿及小腿周径差值与术后1 d比较,术后7 d均明显减小;与本组术后7 d比较,术后14 d亦明显减小,差异具有统计学意义(P<0.05);与对照组同时间段比较,术后7 d大腿周径差值及术后7 d、14 d小腿周径差值的差异均无统计学意义(均P>0.05),术后14 d大腿周径差值差异具有统计学意义(P<0.05)。试验组1例发生DVT(腘静脉)、对照组3例发生DVT(股静脉1例、腘静脉2例),组间差异无统计学意义(P>0.05)。所有患者治疗及随访期间均无严重并发症发生。结论活血通络膏联合低分子肝素钙能较好地减轻THA术后患肢肿胀,明显延长APTT及PT,在安全性能方面与单纯低分子钙素钙相当。Objective： To observe the effectiveness of the application of Huoxue Tongluo ointment combing Low-molecular-weight Heparin Calcium Injection in preventing deep venous thrombosis（DVT） after total hip arthroplasty（THA）. Methods： Sixty-nine patients who underwent unilateral THA were randomly divided into 2groups,33 cases in experimental group,and 36 cases in control group. The control group was treated with Low-molecular-weight Heparin Calcium Injection for 10 d;On the basis of the control group,the experimental group was treated with Huoxue Tongluo ointment for 14 d. Limb deep venous ultrasound and APTT,PT,D-D and PLT in the preoperative and postoperative 7,14 d were detected. Measurement of the thigh and leg circumference in the preoperative 1d and postoperative 1,7,14 d were made. Results： In the experimental group,in postoperative7 d,the APTT and PT were significantly prolonged. Compared with the result on 7 d after operation,the result on14 d was also significantly prolonged. The difference was statistically significant（P〈0.05）. Compared with the control group at the same time,the difference was statistically significant（P〈0.05）. In postoperative 7 d,the D-D in the experimental group was significantly increased. Compared with the result on 7d after operation,the result on14 d was significantly decreased. The difference was statistically significant（P〈0.05）. Compared with the control group at the same time,there was no significant difference in postoperative 7 d（P〉0.05）,however the difference was statistically significant in postoperative 14 d（P〈0.05）. In postoperative 7 d,the PLT in the experimental group was significantly increased. Compared with the result on 7 d after operation,the result on 14 d was also significantly increased. The difference was statistically significant（P〈0.05）. Compared with the control group at the same time,the difference was not significant difference（P〉0.05）. In postoperative 7 d,the thigh and leg circumference in the experimen

关 键 词：关节成形术 置换 髋 静脉血栓形成 术后并发症 活血通络膏 

分 类 号：R687.41[医药卫生—骨科学]