血府逐瘀汤联合低分子肝素钙预防全髋关节置换术后深静脉血栓  

Xuefu Zhuyu decoction combing low-molecular-weight heparin cal-cium injection in preventing deep venous thrombosis after total hip arthroplasty

作　　者：方晴[1] 刘继华[1] 董博 姚洁[1] 袁普卫[1] 朱峰峰 欧国峰[1] FANG Qing;LIU Jihua;DONG Bo;YAO Jie;YUAN Puwei;ZHU Fengfeng;OU Guofeng(The First Clinical Medical College of Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi Province,China;Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi Province,China)

机构地区：[1]陕西中医药大学第一临床医学院,陕西咸阳712046 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《吉林中医药》2018年第9期1030-1033,共4页Jilin Journal of Chinese Medicine

基　　金：咸阳市科学技术研究计划项目(2015K04-02);陕西省科学技术厅中西医结合防治骨退行性疾病研究创新团队项目(2013KJT-26);国家中医药管理局国家中医临床研究基地建设科研专项(JDZX2015280);陕西省科技厅科学技术研究计划项目(16JK1213)

摘　　要：目的观察应用血府逐瘀汤口服联合低分子肝素钙皮下注射预防全髋关节置换术后深静脉血栓的临床效果。方法筛选行单侧全髋关节置换术患者76例,随机分为2组,每组38例。对照组术后给予常规低分子肝素钙皮下注射,试验组除常规给予低分子肝素钙皮下注射外,另加血府逐瘀汤口服,用药时间为2周。比较2组患者术前、术后1、6、13dwells评分,D-二聚体、纤维蛋白原(Fg),活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)及下肢彩超,并记录2组的有效率和不良反应。结果对照组出现深静脉血栓3例,皮下出血2例,消化道出血1例,无肺动脉栓塞、呼吸衰竭发生;试验组出现深静脉血栓1例,皮下出血1例,无肺动脉栓塞、呼吸衰竭发生。2组间术后并发症比较(P>0.05)差异无统计学意义。试验组APTT、PT与术前比较,术后6、13 d均延迟,组间差别有统计意义(P<0.05);试验组D-二聚体、Fg与术前比较,术后6 d增高,与术后6 d相比,术后13 d下降,差异均有统计学意义(P<0.05);试验组wells评分≥3分例数与术前比较,术后6 d增加,与术后6 d相比,术后13 d下降,差异均具有统计学意义(P<0.05)。术后下肢B超确诊试验组发生1例股静脉血栓,1例皮下血肿,对照组发生2例股静脉血栓、1例腘静脉血栓,2例皮下血肿,各组间差异比较无统计学意义(P>0.05)。结论血府逐瘀汤联合低分子肝素钙预防全髋关节置换术后深静脉血栓的临床疗效确定,且可减少单纯使用低分子肝素钙的不良反应。Objective To observe the application of Xuefu Zhuyu decoction combined low-molecularweight heparin calcium to prevent therapeutic clinical effect of deep vein thrombosis after total hip replacement. Methods Seventy-six patients who underwent unilateral THA were randomly divided into 2 groups, 38 cases in experimental group, and 38 cases in control group. The control group postoperatively was treated with low-molecular heparin calcium subcutaneous injections, on the basis of the control group, the experimental group was treated wit Xuefu Zhuyu decoction for two weeks. Compared the two groups of patients with preoperative and postoperative 1, 6, 13 Wells score, D-dimer, fibrinogen（Fg）, activated partial prothrombin time（APTT）, prothrombin time（PT） and lower limbs ultrasound, and record in the two groups of efficient and adverse reactions. Results The control group in deep vein thrombosis（3 cases）, 2 cases of subcutaneous hemorrhage, 1 case of gastrointestinal bleeding, pulmonary embolism and respiratory failure occurred; The experimental group in deep vein thrombosis（1 case）, subcutaneous bleeding in 1 case, pulmonary embolism and respiratory failure occurred. Compared the postoperative complications between the 2 groups（P〈0.05）, there was no obvious diff erence. In the experimental group,in postoperative 6 d, 13 d,the APTT and PT were significantly prolonged, the diff erence had statistical significance between groups（P〈0.05）; In postoperative 6 d,the D-D and Fg in the experimental group was significantly increased. Compared with the result in postoperative 6 days, the result on 13 d was significantly decreased. The diff erence was statistically significant（P〈0.05）. The number of Wells score is greater than three points of experimental group in postoperative 6 d was increased,. Compared with the result in postoperative 6 days,the result on13 d was significantly decreased. The diff erence was statistically significant（P〈0.05）. After the operation, in experimental group, 1

关 键 词：血府逐瘀汤 低分子肝素钙 髋关节置换术 深静脉血栓 

分 类 号：R274.12[医药卫生—中医骨伤科学]