疏血通注射液联合冰黄散外敷对骨科大手术后下肢深静脉血栓形成的影响  

Effect of Shuxuetong Injection Combined with External Application of Binghuang Powder on Lower Extremity Deep Venous Thrombosis After Major Orthopedic Surgery

作　　者：胡伊群 HU Yiqun

机构地区：[1]永康市第一人民医院骨二科,浙江永康321300

出　　处：《新中医》2021年第24期99-103,共5页New Chinese Medicine

摘　　要：目的:观察疏血通注射液联合自拟冰黄散外敷对骨科大手术后下肢深静脉血栓(DVT)的预防效果。方法:选取160例行骨科大手术治疗的患者作为研究对象,随机分为对照组和观察组各80例。对照组术后给予阿司匹林片、低分子肝素钠等常规治疗,观察组在对照组的基础上给予疏血通注射液静脉滴注、冰黄散外敷治疗。观察比较2组DVT发生率、大小腿周径差、凝血功能[D-二聚体(D-D)、凝血酶原时间(PT)、纤维蛋白原(Fib)、活化部分凝血酶原时间(APTT)]、血液流变学指标(血浆黏度、低切全血黏度、高切全血黏度)和炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平及不良反应情况。结果:观察组DVT发生率为15.00%,对照组为28.75%,2组比较,差异有统计学意义(P<0.05)。术后1 d,2组下肢大、小腿周径差比较,差异无统计学意义(P>0.05);术后14 d,2组下肢大、小腿周径差均较术后1 d缩小(P<0.05),且观察组周径值小于对照组(P<0.05)。术后1 d,2组凝血功能指标D-D、PT、Fib、APTT水平比较,差异均无统计学意义(P>0.05);术后14 d,2组D-D、PT、Fib、APTT水平较术后1 d降低(P<0.05),且观察组各项指标低于对照组(P<0.05)。术后1 d,2组CRP、TNF-α、IL-6、IL-8水平比较,差异无统计学意义(P>0.05)。术后14 d,2组CRP、TNF-α、IL-6、TIL-8水平均较术后1 d降低(P<0.05),且观察组各项指标均低于对照组(P<0.05)。术后1 d,2组血浆黏度、低切全血黏度、高切全血黏度比较,差异无统计学意义(P>0.05);术后14 d,2组上述各项血液流变学指标均较术后1 d降低(P<0.05),且观察组各项指标低于对照组(P<0.05)。治疗过程中,2组均未发生与药物相关的不良反应。结论:在常规西药治疗的基础上,疏血通注射液联合冰黄散防治骨科大手术后DVT形成疗效显著,能降低DVT发生率,改善血液循环,减轻炎症反应,且安全性高。Objective:To observe the preventive effect of Shuxuetong injection combined with external application of self-made Binghuang powder on lower extremity deep venous thrombosis(DVT)after major orthopedic surgery.Methods:A total of 160 cases of patients who received major orthopedic surgery were randomly divided into the control group and the observation group,with 80 cases in each group.The control group was treated with routine prevention and treatment including aspirin tablets and low molecular weight heparin sodium,and the observation group was additionally treated with intravenous infusion of Shuxuetong injection and external application of Binghuang powder based on the treatment of the control group.The incidence of DVT,circumference differences between thigh and calf,coagulation function including D-dimer(D-D),prothrombin time(PT),fibrinogen(Fib)and activated partial thromboplastin time(APTT),blood flow indexes including plasma viscosity and whole blood viscosity at low and high shear rates,levels of inflammatory factors including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)as well as adverse reactions in the two groups were observed and compared.Results:The incidence of DVT was 15.00%in the observation group and was 28.75%in the control group,the difference being significant(P<0.05).On the first day after operation,there was no significant difference being found in the comparison of differences of the thigh and calf between the two groups(P>0.05);on the 14th days after operation,the above circumference differences in the two groups were reduced when compared with those on the first day after operation(P<0.05),and the difference in the observation group was smaller than that in the control group(P<0.05).On the first day after operation,there was no significant difference being found in the comparison of levels of D-D,PT,Fib and APTT between the two groups(P>0.05);on the 14th day after operation,the above four levels in the two groups were deceased when com

关 键 词：下肢深静脉血栓 骨科大手术 疏血通注射 冰黄散 凝血功能 

分 类 号：R654.4[医药卫生—外科学]