利伐沙班与血塞通注射液联合使用抑制脊柱术后下肢深静脉血栓形成的效果及血液指标的影响  

Effects of rivaroxaban combined with Xuesaitong injection on deep venous thrombosis of lower extremity after spinal trauma surgery

作　　者：郑琪娈 沈琪[1] 余金聪 袁耀[2] 陈波[2] ZHENG Qiluan;SHEN Qi;YU Jincong;YUAN Yao;CHEN Bo(Outpatient Pharmacy, Hangzhou Red Cross Hospital, Hangzhou 310000, Zhefiang, China;Department of Limb Surgery, Yu yao People＇s Hospital, Yuyao 315400, Zhejiang , China)

机构地区：[1]杭州市红十字会医院门诊西药房 [2]余姚市人民医院关节四肢外科

出　　处：《中国临床药理学与治疗学》2018年第3期337-341,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨利伐沙班与血塞通注射液联合使用预防脊柱术后下肢深静脉血栓(DVT)形成的效果及对患者凝血功能、血流变学指标及其它血生化指标的影响。方法:选取本院脊柱外科接受脊柱手术治疗的患者105例,并随机分为治疗组、对照组1和对照组2,各35例。对照组1术后给予血塞通注射液治疗,对照组2术后给予利伐沙班治疗,治疗组给予血塞通联合利伐沙班治疗。检测并比较3组患者凝血功能、血流变学指标、其他血生化指标的变化;评估并比较3组患者术后5 d DVT发生情况。结果:治疗后3组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均较治疗前显著延长,纤维蛋白原(FIB)水平较治疗前显著降低(P<0.05或P<0.01),且组间差异有统计学意义(P<0.05或P<0.01);治疗后3组全血粘度、血浆粘度、红细胞比容、红细胞刚性指数均较治疗前显著下降,红细胞变形指数较治疗前显著升高(P<0.05或P<0.01),且组间差异具有统计学意义(P<0.05或P<0.01);治疗后3组血小板计数(PLT)、血管内皮素(ET)水平均较治疗前显著升高,D-二聚体(D-D)水平较治疗前显著降低(P<0.01),且组间差异具有统计学意义(P<0.05或P<0.01)。血红蛋白(Hb)治疗前后及组间比较差异无统计学意义(P>0.05);治疗组术后DVT发生率为2.86%显著低于对照组1的14.28%和对照组2的11.42%(P<0.05)。结论:利伐沙班联合血塞通注射液可明显改善血流变学及其它血生化指标水平,进而有效预防脊柱创伤术后DVT形成,安全有效。AIM： To explore the effects of rivaroxaban combined with Xuesaitong injection on deep venous thrombosis（ DVT） formation of lower extremity after spinal trauma surgery and its effects on blood coagulation function,blood rheology and other blood biochemical indexes. METHODS： One hundred and five patients undergone spinal surgery in our hospital were divided into the treatment group and control group 1,control group 2 according to the different treatment methods after surgery,with 35 cases in each. After surgery,the control group 1 was given Xuesaitong injection therapy; the control group 2 was given rivaroxaban,while the treatment group was treated with rivaroxaban intervention and Xuesaitong injection therapy. The changes of coagulation function,hemorheology index and other blood biochemical indexes were detected and compared among the three groups. The incidence of DVT in three groups was evaluated and compared among three groups five days after surgery. RESULTS： After treatment,the PT,APTT and TT of the three groups were significantly prolonged compared with those before treatment; the FIB level was significantly lower than that before treatment（ P〈0. 05 or P 0. 01）,and the difference among the three groups was significant（ P 0. 05 or P 0. 01）. After treatment,the whole blood viscosity,hematocrit,erythrocyte rigidity index of three groups were significantly lower than those before treatment; erythrocyte deformation index was significantly higher than that before treatment（ P 0. 05 or P 0. 01）,and the difference among three groups was significant（ P 0. 05 or P 0. 01）. After treatment,the levels of PLT and ET in the two groups were significantly higher than those before treatment,the D-D level was significantly lower than that before treatment（ P 0. 01）,and there was significant difference among the three groups（ P 0. 05 or P 0. 01）.There was no significant difference in Hb level before and after treatment and among three groups（ P 0. 05）. The incidence of DVT in the treatme

关 键 词：脊柱创伤 深静脉血栓 利伐沙班 血塞通注射液 凝血功能 

分 类 号：R684[医药卫生—骨科学]