苦碟子注射液联合低分子肝素预防全膝关节置换术后下肢深静脉血栓形成的临床研究  

Clinical study of Kudiezi injection combined with low molecular weight heparin in preventing deep venous thrombosis of lower extremities after total knee arthroplasty

作　　者：焦甲勋[1] 朱小丽[1] 索娜[1] 靳宪辉[1] 张庆胜[1] 崔胜杰[1] JIAO Jia-xun;ZHU Xiao-li;SUO Na;JIN Xian-hui;ZHANG Qing-sheng;CUI Sheng-jie(Harrison International Peace Hospital,Hengshui HEBEI 053000,China)

机构地区：[1]哈励逊国际和平医院,河北衡水053000

出　　处：《中国新药与临床杂志》2020年第7期421-424,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：2018年度河北省医学科学研究重点课题计划(20181585)。

摘　　要：目的探讨苦碟子注射液联合低分子肝素预防全膝关节置换术(TKA)后下肢深静脉血栓(DVT)形成的疗效。方法选取本院2017年1月至2019年1月TKA患者共180例,随机分为对照组(n=90)和观察组(n=90)。在常规治疗基础上,对照组手术后12 h给予低分子肝素4 100 AXaIU·d-1,ih;观察组在对照组的基础上加用苦碟子注射液40 mL,ivgtt,qd,2组均用药14 d。比较2组患侧肿胀程度、疼痛程度、血液流变学指标和炎性因子、D-二聚体、血浆凝血功能水平及不良反应发生情况。进行术后30 d随访,统计DVT发生率。结果术后7 d开始,与对照组相比,观察组患者的全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数和血细胞比容下降(P <0.05),肿瘤坏死因子α、白细胞介素(IL)-6、IL-8和D-二聚体水平降低(P <0.05),凝血酶原时间、活化部分凝血活酶时间无显著变化(P> 0.05),疼痛程度及患肢肿胀程度明显减轻(P <0.05)。观察组与对照组不良反应发生率无显著差异(6%vs. 4%,P> 0.05)。术后30 d,观察组DVT发生率显著低于对照组(4%vs. 13%,P <0.05)。结论苦碟子注射液联合低分子肝素能够有效预防TKA术后下肢DVT的发生,显著改善患者血液流变学指标,减轻机体炎症反应,减轻患者疼痛程度及患肢肿胀程度,且不良反应轻微。AIM To investigate the clinical effects of Kudiezi injection combined with low-molecular-weight heparin on preventing deep venous thrombosis(DVT) of lower extremities after total knee arthroplasty(TKA). METHODS Totally 180 patients with TKA in our hospital from January 2017 to January 2019 were divided randomly into observation group(n = 90) and control group(n = 90). Besides conventional treatments,the control group was given low-molecular-weight heparin(4 100 AXaIU·d-1, ih) 12 hours after operation, while the observation group was given Kudiezi injection(40 mL, ivgtt, qd) based on the administration of the control group, with a 14-day administration time in both groups. The incidence of DVT, the degree of limb swelling and pain, and the level of hemorheology indices,inflammatory factors and D-dimer, coagulation function, and adverse reactions were observed and compared between the two groups. RESULTS One week after the operation, compared with the control group, the hemorheology indices of whole high blood viscosity, whole low blood viscosity,plasma viscosity, maximum aggression index of erythrocyte, and hematocrit significantly as well as the inflammatory factors of TNF-α, IL-6, IL-8 and the level of D-dimer decreased(P < 0.05) in the observation group. There was no significant change in prothrombin time or activated partial thromboplastin time between the two groups(P > 0.05). The degree of limb swelling and pain in the observation group was statistically lower than that of the control group(P < 0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group(6% vs. 4%,P > 0.05). Thirty days after the operation, the incidence of DVT in the observation group was statistically lower than that in the control group(4% vs. 13%,P < 0.05). CONCLUSION Treatment of Kudiezi injection combined with low-molecular-weight heparin can effectively prevent the DVT incidence of lower extremities in patients after TKA,and it can significantly improve hemorheo

关 键 词：苦碟子注射液 肝素 低分子量 关节成形术 置换 膝 静脉血栓形成 

分 类 号：R543[医药卫生—心血管疾病]